[00:00:00] And that’s the way I describe it, when patients come in and and request the treatment. I say to them, actually, what you’re paying for here isn’t the white braces, the aligners, it is the end result, the tools. The brace is just a tool that I use to get you there, you know, and and the pathway might not be straight. It might be a bit windy. We’re having difficulty moving teeth. We might have to go back to the drawing board and make more aligners. We might have to change things. It’s a learning curve. But the beauty of orthodontics is it allows you to navigate through that path. And if things don’t go the way you had initially planned, teeth might move differently. Then you can always move things back usually. So again, that’s I like to think that orthodontics is quite a safe profession.

[00:00:42] 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] It gives me great pleasure to welcome Josh Rowlie onto the Dental Leaders podcast today. Somebody who’s recently burst onto the scene, certainly in the social media feeds doing a lot of teaching for various aligner companies. And more recently has joined the US Academy, heading up and spearheading our clear aligner programme. Josh is somebody who I define as an ortho dentist, although he’s a specialist orthodontist. His work sits in that meeting place between restorative dentistry, cosmetic dentistry and specialist orthodontic treatment. Somebody who just recently burst onto the scene of orthodontic teaching. And certainly when I saw some stuff on Facebook, I thought, There’s no way he’s a specialist orthodontist. He looks far too young, but he is. And, you know, having spoken to people like TIFF and Ross who’ve seen and heard him teach. We’re all very impressed. And so, Josh, we usually start these interviews by just asking a little bit about your background, where you grew up, what your schooling was like and then how you finally got into dentistry.

[00:02:06] Yeah, yeah. I mean, grew up not far from where I’m living now in Perth, in Scotland and went to school in the same area. And then I went to high school in Dundee and we always get asked, you know, why did we get into dentistry? And it was actually through more personal experience. You know, I’ve got this spiel in my head from seeing it so often now. So it comes naturally in this situation. But it it comes because when I was younger, you know, I bumped my front teeth. It needed some work done Root Canal Crown, things like that. Well, H, was that Josh. So that would have been probably about 14, maybe 15. Of was, it was taking a bite of the school railings. You know, the the hands go through the railings, but the teeth don’t go on to the railing kind of situation. And I had a very good dentist at the time, Dr Adela Laverick. And I guess you can fix me up and I was a bit kind of like, Wow, that was just amazing. And I guess I must have shown some interest at the time because she invited me back in and to kind of shadow just the tree for an afternoon, a bit like work experience because I was kind of coming up to fourth, fifth year at school and I was already thinking, you know, jobs wise, we need to really think about what I want to do with my life.

[00:03:14] So very grateful for her, her reaching her hand out and kind of offering me a chance to kind of over what she was doing. And yeah, I guess it was like a natural progression that I really enjoyed it. I’m a very kind of manual person in the sense that if I wasn’t doing dentistry, I think I’d be like a mechanic or something like that. I would want to work with my hands in some way. And I guess dentistry for me, because it kind of bridges the gap between, you know, medicine and almost art in a way can be quite creative. And now with orthodontics engineering, you know, forces vectors, things like that. And also the materials. I mean, you know, Ross, he’s he’s a materials man. You know, he’s the scientist. Yeah, but you know, I like working with intricate things. And for me, that’s why I orthodontics as well. I went to university in Dundee, a five year course there. I then did, you know, as everyone does, you’re a vet quite close to home. Actually, I moved home for a year to do my bit and again it was. I kind of went to my family dentist at the time and worked there for a year. And then even from university, I got into the backhed. I was quite involved in a lot of post post-graduate kind of associations and things like that.

[00:04:25] So it was that whilst he was a student, Joshua, he

[00:04:28] Was a man of the when I was in my fourth year, I was the student representative for the BCD or kind of Dundee University. And again, you know, I owe a lot of thanks to the BCD as well from kind of offering me an opportunity to get involved with them at an early age. You know, it kind of set me apart from my peers when applying for VTT positions and jobs because of the BCD, I met Elaine Halley, who a lot of people know her industry. Yeah, yeah. When I finished my vet, you know, she knew that I wanted to do cosmetic work. She I had a good understanding of smell, design, getting an understanding of, you know, at the time, you know, one of the buzzwords was kind of minimally invasive dentistry. So she kind of knew what my ethics lay and she offered me a job. So she offered me a kind of a two day a week position in her private practise in Edinburgh. I took it on and was under her wing for a year and a half, and it was great. It taught me a lot. It kind of set my ethics and dentistry really well. You’re probably going to ask me this later, but I’ll probably jump in now. And it was predominantly because I’ve heard that I am doing what I’m doing now because of the fact that it was a very, like I said, minimally invasive ethical ethics.

[00:05:34] In that practise. They did a lot of Elaine bleaching and bonding, particularly with Invisalign. So I started my orthodontic career with Invisalign. And as you said before, it’s a bit like that kind of black box situation sometimes whereby I was doing a lot of cases and I was I had a basic understanding of what what was an. Involved with that, you know, you put you take your records, you do a treatment plan and you kind of you send it away and you get your aligners back. But there were still very much a black box. It was still very much this area of sometimes unknown. And I guess, you know, one of these people that if I want to do something, I want to do it properly when I understand it. And it got to the point where I was taking on some difficult cases and I thought, OK, so it seems to be working, but I don’t quite understand the full picture here, and that’s what led me to then want to do what it takes to go back and do a three year master’s course so I could actually understand what’s in the box. Yeah. So that’s a very quick kind of run through of my career so far. Kind of a couple of shout outs in there to those that have influenced me and kind of pushed me in the right direction.

[00:06:40] Absolutely. And as I’ve got so many questions based on what you’ve just said there, so well, I’ll just I’ll pepper my way through them. But one of the things is that as a young, newly qualified dentist, you’re getting the opportunity to work at Cherry Bank, which I assume where it was that you got you got the job is like a one in a million shot, right?

[00:07:02] It was, yeah, it was almost at the time. You know, I was so grateful for just being offered, even just a two day position. You know, all my friends were leaving VTE and they were getting, you know, five days a week, you know, sometimes 50 hours in an NHS mixed practise, you know, and here’s me just thinking, right, I’m going to just take a chance here and start with whatever patients. They give me just two days a week and actually within about four or five months, I was up to three days. I was getting busier. They were giving me new patients, which is fantastic. You know, I was getting good case acceptance, you know, because of the fact that I had more time, I could spend that time planning cases, really getting to know my patients well, and they were agreeing to some bigger plans not going to lie. It was at my depth in some cases, but that’s how you learn. I had good mentors, so although there might have been cases that I found difficult or, you know, there for someone young in their career, you think, OK, taking on some of that’s quite big. But when you’ve got someone there to guide you, it’s not as scary and you do have to go out with your comfort zone to develop in a great, you know, I say that to everyone. It’s important to understand what your limitations are by having good people around you is massive. You know, it’s the biggest thing for progressing your career.

[00:08:16] What advice would you give to a young UP-AND-COMING dentist who wants that one in a million job? You know, you obviously put yourself out there, you know, put yourself forward. As the representative for the BBC, was that the decision that you made that led to you get in that role there? Was there an interview process with Elaine?

[00:08:37] There would have been at the time, I seem to recall that I remember getting an email from the BBC. I’d sign up for the newsletter and they were they were just about to start doing student representatives. I think they might have actually been the first one and they were offering positions to students in their fourth or fifth year. I think it was to come on board whereby you’d have to be a member first and then they wanted to spread, you know, the mantra of the BCD within the Dental skills, which is still what they’re doing now, and I’m still involved in that. But it was that decision that me kind of applying for that, handing in a CV kind of telling them kind of what I want to get on my career. And I seemed to recall it was Richard Field who is also, I think or has been a mentor in the IRS. He interviewed me, actually. I remember kind of speaking to him on the phone and, you know, probably all credit to him as well for giving me that position. I never mentioned that up until that point. That’s it. Yeah. And and I met him at the BCD conference, which would have been in London. I think that year. I honestly don’t know what year that had been, maybe 2012.

[00:09:44] And so, yeah, that decision then led to me meeting the right people at the OECD, and it led to me then kind of knowing if I should actually point out bringing the story way back that I actually made my mum and myself and my brother. We went to Elaine’s practise in Perth, our hometown, when she opened it, and that was when her practise was. I think she lived above the practise. It was like a detached house and she built it and she lived above it. Now is the same practise, but she’s she’s moved out and it’s a bigger, more surgeries. And yeah, we used to go there. I used to go there as a child. I think she sent me, you know, to the orthodontist and she couldn’t do the work and things like that. So it was almost like full circle again when I met Alan again at the BCD conference in London. And that’s where it sparked that she was like, Oh, this guy, you know, I know of him, I know his family and and yeah, and just me being there. She was almost like a wow, you know, this guy is a bit switched on. He’s here already. He’s only in his fourth year. And then again, you know, yeah. So sorry, I’m going off topic.

[00:10:44] No, no, no. That’s cool. It’s my story. It’s like seven minutes, isn’t it? That’s getting it to you. Yeah, it’s like pure serendipity. Like. This is the I can’t remember the name of the movie now, but it’s it’s something that you do as a child or something you do earlier on in life that impacts what happens. The butterfly effect. I don’t know if you’ve seen that movie, it is.

[00:11:05] Absolutely. Yeah, no, it’s exactly that. Actually, it’s making me think about, yeah, this is like the way it works is so strange.

[00:11:12] Yeah. Yeah, so, so so just just going back to earlier life. And what was your childhood like growing up? Were you a geeky student kid? Were you excelling at school sports, that sort of thing? What memories have you got to be childhood

[00:11:27] Going deep here or going deep? The, you know, as a primary child, if you’re going that far back, you know, probably misbehaved on almost all of my school report. So it was, you know, needs to concentrate more and I could try harder. I think that every single plate on the fridge at home, you know, all my reports, they all said the same thing. Yeah, and I was quite young for my year. I was a January birthday and one of the youngest in my primary year, and actually I repeated primary seven in two schools. So my primary school and my hometown, I did seven eight and then I repeated P7 again when I went to Dundee High. They have a junior school in a high school, and actually that was probably one of the best decisions I think my parents ever made for me was that I was just too early. I hadn’t matured enough and if I had continued along that timeline, where if I hadn’t repeated a year earlier instead of my exams a year earlier, the I just feel like there became a point where I just knew that I needed to switch on. In my third fourth year, I was like, If I don’t buck up here, you know, I’m not going to lead to much. So, yeah, the extra year help, for sure. And you know, I had some great friends at school and actually some of my friends moved with me, and I think that was also part of the decision my parents made.

[00:12:38] They wanted me to be with people who I knew and I played tennis with, I don’t know, younger, so I was going into their year. So I had friends in a new school already and then high school thinking back, Hey, you remember like first, second, third year in high school. I remember the exam years, the kind of the crucial years. And but mostly I remember the sport, remember the rugby rugby at school. You know, that was that was the I enjoyed was going up to the games and playing on weekends and hockey and things as well. And then, yeah, I never did that well in the prelims as it were and leading up to Christmas, always, you know, got C’s B’s if I was lucky. And when it came to the exams at the end of that academic year, I guess I just kind of matured in that very short space of time and and I did well in exams. I don’t think that I had my eyes set on dentistry when I did my fourth year exams in terms of the standard grades, but certainly by my hires. I knew I was aiming for that position of needing five A’s at higher to go into the dentistry or medicine or potentially veterinary. I knew I want to do something like that. So. So that’s that’s my story in terms of kind of early to late teens.

[00:13:51] So growing up. Obviously, your inspiration for dentistry maybe started as early as, you know, being a patient at Cherry Bank right through to having the work experience as a 14 year old. Was there any other influence from your parents or did they come from a medical background or anything? What what, what? What was their profession?

[00:14:09] I mean, good question. You know, you find that in our industry, it does kind of stay in the family. But no, my my family or even extended family are not medical in the slightest. My mom worked in a solicitor’s office and my dad was a commercial diver, so he worked offshore. When you mentioned about my background and things. Yeah. And yeah, as when I was younger and my dad used to go away for a bit of time. You know, sometimes two or even three months at a time and came back, it was just fine. You know, my mom worked, you know, in a job that allowed us to do that. And I was we were at school. She could still take us dollar sports and things. So yeah, I mean, you know, big credit to to my parents for for for helping me in younger years and everything like that. But when a lot of people say, Oh, so your dad was away a lot when you’re younger, but actually when he was at home, you know, he was at home. So like summer holidays and things, he would try and work his shift patterns around holidays. And it’s, you know, he wasn’t nine to five. He was always there. When he’s at home, it’s like, that’s sometimes one thing I a bit jealous of is those that work offshore or have jobs where you’re on a shift pattern like that is that, you know, when you’re away, you’re you’re at work and things like that. But when you’re home, work is, you know, you don’t get contacted, you know what I mean? Whereas sometimes with dentistry, you can take a work home with you. And I do sometimes find it hard to switch off. And there are things that you know, sometimes are always in the back of your mind. But yeah, maybe that’s something I need to work on.

[00:15:29] You and me, both Josh, you and me both. You know, it’s it’s one of those challenges that you know when when you’re a somebody who works incredibly hard or, you know, takes your profession seriously that it ends up becoming consuming, right? And as you said, your dad was away a lot when you were younger, but when he was in the room, he was in the room and

[00:15:49] He told me so.

[00:15:50] Yeah, and and. When you know, when we’re at home with our kids and we’ve got social media on our phones or we’ve got all these other all these other distractions, we’re there, but we’re not really there.

[00:16:02] I was going to say, I remember because my dad used to being a diver, you’d be, you know, in the bell, you’d be in the chamber for that time that you’re working. He’s the phone home, you know, with a very squeaky voice, you know, the helium voice. And you know, he’d be on the phone for an hour, you know, every other night, you know, and he’d be trying to try to understand them. And it’s sometimes quite difficult. My mom is very good understanding what you’re seeing, but even as a child, I was, I was kind of my mother, would you see? But yeah, it’s funny, but it’s been. He’s been out of that for a while now. He retired a few years ago now. He never wanted me to do that career. He was in the Navy, and that’s how we kind of led to him to become a commercial diver. And he never wanted that for me and my brother. I’ve always, I’ve always said was like a bit of a joke if all else fails. And for any reason, I would get struck off or candy dentistry. I’ve always got. I’ve always got commercial diving. I could fall back on just riding my my dad’s coattails. Maybe it’s hard and very fickle industry that now, funnily enough, my brother is an engineer and he’s almost superseded my my father in the sense that he works for a company or not anymore, actually. But he used to work for a company robot called who design underwater equipment robots essentially to kind of do the job that my dad used to do. So there’s there’s less of a need for people to be at the bottom of the seabed now.

[00:17:16] We’re going to we’re going to start. We’re going to talk about that later in terms of robots that are taking over our orthodontist jobs as well later on, when we when we talk about direct to consumer orthodontics, but just just going back to where the inspiration from your father, which is, you know, he didn’t want you to do what he was doing because either it was a hard slog or he wanted a better life for his kids, right?

[00:17:36] I think I think I think it was just too dangerous, I think. I mean, I don’t know if you’ve ever seen the BBC documentary. I think it’s called Last Breath worth a watch. Okay. You know, I think it’s an hour long and it just tells you the story of a commercial diver who was at the bottom of the sea bed, his umbilical, his lifeline got tethered and snaps, and he was at the bottom of the sea bed for about 20 minutes with no oxygen. And it just told the story of how it happened, how we survived and stuff. It’s amazing the story, but worth worth an hour.

[00:18:07] I’ll give. I’ll give that a shot. So moving on from there, Josh, were you inspired to do something different? Were you encouraged to go towards the medical sciences? And was education a big thing for your parents? Were you pushed in that direction at all?

[00:18:22] I mean, they obviously sent me to private school is a private school, and I think just being in that kind of environment environment. Yeah, I think that it was never a push to, you know, like you have to go into medicine. It was very much my choice, but I just feel like the way that the school was aiming and they have numbers and they have their things they have to reach. And, you know, a lot of people in my year, you know, they went on to do medicine, particularly a good education that people in my year went onto the medicine and there was two in my year. Funnily enough, it was my girlfriend at the time. We both got into dentistry at the same university and and lawyers and things like that. So I guess it’s just the funnel effect of kind of the education at private school education that they try and get you into these university programmes. Yeah, no. It was completely my choice. And you know, looking back, you know, so glad I did that, you know?

[00:19:15] Yeah, yeah. So fast forward in now back to where we left off, which was, you know, the black box trying to figure out the mechanics of these teeth shifting around and how they move. And almost like the engineering, you wanted to know the ins and outs of it, right? And so what was what was your next sort of Segway into? I’m now going to spend what is it, three years full time of your life chucking yourself back into education? Or is it for?

[00:19:44] It’s three years. Yeah. And a lot of people ask, You know how I did it and things. And it’s it’s a it’s a bit of a funny topic, actually. So let’s just call it the more traditional routes into orthodontics. So an orthodontic specialist would be to do your VTE. You probably work in practise or you do your core training. A lot of the time you would probably have to spend two or even three years in hospital rotations doing different clinics. You would maybe do core training one to maybe apply for orthodontics, maybe not get in that year and then you’d maybe do core training three and the need apply for a residency. And throughout that whole process, you are interviewing every stage. You are not really guaranteed where you going to go. You know, you apply to national recruitment and you might not interview well and you get ranked 30th of how many species there are. And you might be going down south or going up north to to do this. And I guess having and was working with Cherry Bank with Elaine at the time, you know, I just wanted to know how to do orthodontics. I never went on this master’s course knowing that I was going to get a speciality status afterwards.

[00:20:49] That’s not what I did it for. I did it because I just wanted the education I wanted to know. What I was doing, basically, and they even told me when I joined the chorus, you know, we can’t guarantee you will be on the specialist list, and I said that actually isn’t a big deal for me. So I didn’t do it, the traditional route I should point out. I didn’t want to go back to do clinics in oral surgery, in peace or even to a certain degree. I didn’t want to almost the skill I’d spent all this time with mentors learning how to do some work, learning how to to have the patient experience the patient journey. It wasn’t really the kind of dentistry I wanted to do. Hospital dentistry is very, very different from practise, especially private practise. And it wasn’t something I wanted to do. I didn’t want to take a step back in a way, both financially as well. And so it came about that I went into the Edinburgh University Dental School just to enquire about how I go about doing this, you know, and I got shown around and the consultant, Dr McGuinness at the time, he kind of talked me around and he said, Yeah, if you want to kind of apply for a post, it can be very difficult because of the nature of the fact that if you’re only applying for a master’s course university, you know they will favour overseas students because of the fact that they pay more.

[00:22:04] So it’s very unlikely that you will apply for this role and get in because the only UK positions are those that are taken up by the NHS pathway, those that are doing it, the more traditional route. And what happened was about two weeks after I’d gone in to enquire about it. They had someone pull out, so they had an overseas student, I believe, from Malaysia, who pulled up quite last minute. And this would have been in about kind of August time. And the course was due to start in September, and they had exhausted their lists of people who who were backups. And I was like the only one having never interviewed in the first place, but sure that I wanted to maybe interview next year for it, and they literally phoned me up and said, We’ve had this person drop out. Do you want an opportunity to do your three years training, you know, now? And it was like, you know, one in a million, you know, it’s like the scratchcard scenario.

[00:22:55] And then,

[00:22:57] Yeah, you know, they literally told them that. And they’re like, Absolutely. Even though I had so many unknowns in terms of money, in terms of finishing where I was at that time and yet and it was just one of these, you know, right place, right time situations like, you know, speaking to you today, Prav, I’m just realising, actually, I’ve been very lucky with citizens for a number

[00:23:15] Of years to connect the dots, Josh.

[00:23:18] I said, Yeah, and and yeah, and the first thing I did was obviously phoned home and from the bank can be like, Can I afford this? And then the next day, you know, I had I sat down with Elaine and I said, Look, I’ve been given this opportunity. You know that I enjoy my orthodontics. Can we work something out here? And she was very positive about the whole thing, which really kind of pushed me into doing it. And she was very, you know, very grateful for the fact that she almost let me terminate my associate contract a bit early to start this course. You know, usually you’d be tied in for, say, three months, which is understandable. But she said, right do a month or two and then maybe work the evening weekend just to finish off some of your bigger cases. And, you know, basically give me a phone when you’re finished, you know, and we’ll be back in the thing. Yeah, and and yeah, so that is how I got into the orthodontics, the master’s programme. I’m not going to lie. It did make waves. And in fact, that I do believe that the door for that entry is no clue. So I don’t think if you were to apply now for a master’s programme at universities and certainly in Scotland, I don’t can’t really say about England.

[00:24:22] You’d be you’d be looked at because they would just favour overseas students paying more and things like that. And and even to a certain degree, the GDC, you know, I feel like when I first went on that programme, I was a bit of a pariah. I was like that person that I who’s that guy doing that orthodontic? You know, I was a very standalone and it was a wee bit lonely at that time. I was thinking of why are people picking me out? I just want to know more. You know, I have not done anything wrong here, but it felt like I was doing something wrong actually at the time. And like I said, you know, I went to the whole programme, you know, did well. I think in my in my final year, I got like a distinction for my research and things. And and, you know, I really did enjoy my time, my three years in the hospital, some really nice staff there. We got we got to know each other really well and really nice patients.

[00:25:08] And unlike those that are doing the NHS pathway, whereby when they finished their specialist training, they automatically get put on the specialist register, I essentially had to apply for equivalence. So as if I was an overseas student applying for GDC less. No more specialism, no in the UK, I’d have to show off my work, show off my experience, and that’s what I did. I just made a portfolio of all the cases I did all the research, all the work that I’d done, literally a pile of paper about this big. It’s just such a such a fast. But you know, a sense it took a long time. Covid slowed it all down. But but yeah, eventually I think it was about a year and a half ago. Yeah, got got that magic letter and just said, Yep, you’re on the list. Thank you very much. And, you know, it’s good to open a bottle of champagne that you think it’s kind of it was almost like the final hurdle in a way, but I never intended to get on in the first place. But as I as I happened, you know, it became apparent that I could do that. And so why not?

[00:26:06] And you’d done the graft to get there, right? So well, that’s it.

[00:26:09] Yeah, yeah. It was never after the title or the names or the letters. It was more just the education. But having is a cherry on top and as as I was going to go. I know you’ve got lots of questions. I was going to kind of go into a little bit that from a patient’s perspective, I don’t honestly think that being having a title such as consultant specialist, even to a certain degree, you know, general dentists with an interest in I don’t know how much the general population really know or understand that, to be honest with you. And in some cases, if you call yourself an expert and something, someone who isn’t then orientated might think, Oh, they probably did almost rate that as higher than someone who would maybe call themself specialist or a consultant. Because in some industries, if consulting, you don’t really do anything, you just consult on work. So sometimes you can go too far. And from a marketing point of view, actually, patients might think, Oh, I’d rather go to that expert over there.

[00:27:00] So it

[00:27:00] Doesn’t really make a difference for them, actually, as what I’ve found, you know,

[00:27:03] You’ve hit the nail on the head. Josh, I was I was speaking to one of my one of my, shall we say, sales team or treatment coordinators in my own clinic last week and I overheard her on the phone. Now one of our clinicians, stroke co-owners of the practise is a clinical dental technician, right? And a clinical dental technician is somebody who can treat patients as well as manufacture the dentures, right as long as it’s affordable. So he was she was speaking to the patient and saying, Oh, well, you know, Mark, he’s he’s a clinical dental technician and, you know, he’ll make your dentures and this that you overheard the conversation. And I thought to myself, what will the patient derive from the fact that this person’s a clinical dental technician? So. So we sat down and said, OK, yes, Kerry, I think it would probably be better to say Mack is a denture expert. He’s got over 30 years of experience hand crafting these dentures, placing them in people’s mouths so they look unbelievably natural and fit perfectly. It’s just like, Yeah, you’re right. But sometimes we tend to use terminology lexicon that perhaps either confuses the patient or they don’t understand the importance of the specialist title. What that means, the work that’s gone into it, that you’ve just shared with me that, you know, going into that situation where you were the black sheep, so to speak. And you know, and then getting towards the end of it and then struggling to get the title and finally getting it there. So yeah, I truly believe that from a marketing point of view or even just basic patient communication, the words that we use or choose to use are so important. So just just on that topic, Josh, when you’re speaking to your own patients or having conversations with them, does the specialist title come into play and sort of how do you articulate that? Not at all.

[00:28:51] No, I mean, I generally patients, I mean, I I could do a lot more in terms of marketing myself, actually. Sure, we’re busy in practise and we get a lot of patient referrals, you know, self referrals they’ve had. I been doing a while now in the sense that the cases I’m finishing a lot of the time when the patient comes in or see on the screen. This is a word of mouth referral, which is great because building a clinic, that’s they’re the they’re the ones you want. Yeah, you want the ones that I’ve had a friend who’s had orthodontics and says, I want the same as my my friend that they look fantastic. Can I please have that? They’ve already sold it to themselves. They’re aware of the costs. They’re aware of what’s involved already. It’s a case of this is what we need to do. And you know, there’s not much sales involved in it, really. They’ve done it for you. But because I’m a bit more at the moment, I’m a bit of a one man band in the sense have therapists and nursing team and the staff surrounding me.

[00:29:43] But it is very much myself as the orthodontist and I see myself. Maybe in the future, when the clinic grows a bit more, I will need help to do marketing and it might be that I hire someone or, you know, work with people a couple of hours a week to do more of that. Sure, it’s I’m not a businessman. I am a wet fingered dentist slash orthodontist, and I enjoy what I do. I understand that nowadays you have to market yourselves and it is almost a job to do your social media, to do your website. And I’m not a jack of all trades. I’d rather, you know, the best person for that job should do that job. I’m not that person, but it’s time consuming. You know yourself, you know, having an active social media, it’s time. I don’t know how people do it. If I’m perfectly honest. Some of the, you know, the stars in our industry that would call themselves influencers. I hate that term. But yeah, but they call them this. Yeah, they must hire people to do some of that work.

[00:30:38] And it’s a whole it’s a whole conversation in itself, Josh, that yeah, I know we’ve had a few of these people on the show incredibly successful in marketing themselves. But you know, along with that comes things. Like, you know, trolling, you know, the constant distraction of dealing with messages and DMs and things like that and trying to emotionally detach yourself from that.

[00:31:02] I think that’s a big problem in our industry now. I try and stay clear of that, but I understand it’s a necessary evil. You have to do it the way now, and I’d be the first person to delete all my social media, you know, if I if I could, but it’s almost like, you can’t. Now that there’ll be Facebook money next, you know, and it will be you’ll be paying for things with your with your coins online and it will all become this big thing. I mean, again, I’m not going to go into too much about where the world is going, but yeah, it’s one of these things I like. It’s been a while since I’ve seen any, but there’s a Netflix series as it Black Mirror, and that kind of delves into the problems that kind of lie in what you’d think could be like a simple, a better technology, but it almost immediately goes into the dark side of it, which is fantastic to so true.

[00:31:49] Blows your mind. And so, Josh, you got the the badge and the letters after your name. What happened next? You fast forward to your in practise. Now, just tell us a little bit about where you practise in what you do in the.

[00:32:02] At the moment, I work in between two practises. I work in South Side Dental care, particularly the clinic that I run is the South Side Orthodontic Clinic, which is its own clinic within a practise. I worked for LeAnn Brunson, who is the practise owner. I did some part time work with her while I was doing my three years training just in the evenings, and it just led to me taking more hours as I got busy. So when I finished my my full time training, I took on more hours at that clinic. The other practise I work is bite dentistry. I work with Ima O’Connell, who’s an implant dentist. Some people would have heard her lecturing on implants and fine things. And again, you know, a lot of credit to demur. I worked with her both before and during my time training, and again it was a natural progression to take a more hours with her when I’d finished. So my working life is quite different in the two practises in the sense that I am not a traditional orthodontist. I still do a lot of restorative dentistry and and bites dentistry. You know, I I do orthodontic Dental, so it is actually slowly building up into almost a purely orthodontic clinic. But for instance, yesterday I had a gentleman come in and we prepared up two to two veneers. My background has always been in restorative dentistry. I went on Christopher Orr’s year long course when I worked, when I was just out of it, and then I enjoyed that so much and I gained so much from that.

[00:33:29] I then went on and did. His is kind of like a more advanced course in a way where it really delves into occlusion. And one thing that is not taught at any level in academia, you know, in the hospital situation is occlusion, really. And you’d think that as an orthodontist, you would be the one to know occlusion the most. But actually, I learnt occlusion from Chrysler, actually. And, you know, and feeding that into the orthodontics, it was just piecing all the pieces of the puzzle together, but going back so to to to my practise. So I work two days a week out, bites Monday and Friday, and I work two three days a week at South Side and at South Side as a fully orthodontic clinic, we accept NHS referrals and private referrals. I’m slowly gathering a good network of Dental dentists around Edinburgh who we work with and about dentistry. It is very much a very solid patient base that have been with the practise for a very long time, and I provide general dentistry and cosmetic and orthodontics for them. And it’s I enjoy working at both for both, for very different reasons. And I would say I enjoy the restorative part just as much as I enjoy the orthodontic part. And there’s probably very few orthodontists that do drilling and filling in on layers, veneers and things out there.

[00:34:46] It’s really, really interesting. I don’t think I’ve ever come across an orthodontist who does the ortho, the whole ortho restorative piece, which now sort of make sense while your alignment with sort of teeth, creches philosophy with the whole AB minimally invasive. And you know, TIFF has said some quite bold statements in the past when, when, when I’ve spoken to him and one of them is if you’re a G.D.P. and you can’t do Ortho, I will not sit in your chair. Yes. Yeah. And it’s a pretty bold statement for him to make. But I understand why. And you know, if you’re doing it, if you’re the guy who is the reverse to you. So was that all the restorative training first and then doesn’t have a true understanding of the, you know, the continually shifting teeth over time, that teeth move? I know that from personal experience, I’ve developed a gap in my tooth that definitely wasn’t there four or five years ago, right? And I’ve never had Ortho as a kid. So there is that continual tooth movement, and if there’s a restorative dentist, you ignore Ortho. You’re doing your patients a disservice, I believe

[00:35:55] It’s it’s a topic I quite enjoyed talking about because of the fact that, you know, it’s more and more industry is going into like an amalgamation of everything in the sense that I’m the first to say you shouldn’t be a jack of all trades, but you should have a general view of all the specialities. That’s that’s my opinion. And when a patient comes in your chair, you definitely don’t ring fence them into a certain category or you in a way you don’t limit what they can have. So everything should be dealt with in the beginning when a patient, when the chair from a comprehensive point of view, you know, looking at where they’ve come from, how have they got into the situation that they’re in now? I think when when I was talking on the on the level to a line, of course, when you were there, I had a slide. It was like the what’s it called again, like the five W’s and an h like the where, how who kind of, you know, as a dentist, you have to be a bit of a detective in the beginning to understand where they’ve come from, because only once you know where they’ve come from, can you then work out where you want to get to in a way. And yeah, I understand what you’re saying about the fact that there was dentists that maybe don’t do orthodontics. It’s a whole different mindset. Then it’s an understanding that it’s very different from some general dentistry, drilling and filling. And yeah, if you’re not doing that kind of work, there is very much again like a limb missing in your, you know, your bag of tricks that actually, yeah, I get what you’re saying in terms of statement as a bold statement, for sure. But I do. I do agree, actually in the sense that everyone should have a good understanding of all the specialities, but not necessarily doing it. No, certainly be able to understand when it might be needed and then make the appropriate referral if they’re not comfortable doing it themselves.

[00:37:34] Absolutely. And so these two statements that work really well encompass all of that. And there’s this tiffs, which is, you know, if you don’t know how to or you can’t, you don’t have the knowledge to be able to sort of say, Look, this patient treatment plan should be a little bit of pre alignment before us stick some porcelain on there or Ross’s. You know, Ross’s saying there’s always coming out with which is you don’t know what you don’t know, right? And yeah, and so if you don’t know that orthodontic, you don’t know what’s best for that patient, right? And so you end up doing a disservice to your patients. But flipping that around, you know, it’s rare, that rare. I’ve never come across an orthodontist who will do also restorative dentist. You talk about sticking veneers on patients and stuff like that that you’ve got you’ve got you’re providing the complete treatment for the patient. So what proportion of your dentistry would you say is strictly ortho versus sort of restorative as well?

[00:38:35] I would say it’s probably 70 or 30 restorative prosthetic. Actually, almost all my adult cases have some form of research development in them, and I work a lot with my referring dentists in the sense that when they refer a patient to me, I don’t want to just be that person that takes the case and sends it back to see. Right. Thank you very much. That’s them done. You know, I sit down with a patient and I plan only for the orthodontics. I plan for the restorative the cosmetic part. And so I would I really enjoy sending almost work away if a patient has sent me a story of a dentist who sent me a patient and the patient has said, Oh, I want some my lower teeth straightens, you know, a very commonly seen, and then I sit down with them. I look at the models, the photographs, and we say, OK, so this is how your teeth will look when they’re straighter. But you’ve got some way around your teeth, you’ve got a, you know, some discolouration on some of the teeth like that crown up there. I take the time, even though I don’t have to, in a sense, to show the patient the complete overview of their case. And it means that I build a nice relationship with them. They’re, you know, confident in the work that I’m about to do. But also it means that when I’m finished the orthodontics, I put the teeth in the right place and I send the patient back to the dentist. And the patient has already agreed to some whitening, replacing a crown. They’re actually wanting some composite bonding, you know, have that back, you know, I’m making some money from this. You’re making some money, the patients happy. We have given the patient a complete plan.

[00:39:58] The dentists never sent the patient to me knowing that that was going to be done. But I like to give back and using the the way that I work is very much it’s a it’s a comprehensive view. We look at doing small designs for every patient, if not like a mock up in the mouth. I mean, a step too far for some patients, but certainly doing a 2D smile design when we’re just working with keynote or PowerPoint templates to work out where the smile should be. It’s a starting point in any and any treatment, orthodontic or restorative, and we we just take the time to just help the patient understand what they might need. And a lot of patients might not agree to the full plan, and that’s fine. But they are fully aware and they’re fully consented to what would be a gold standard plan. And we work backwards from that. And a lot of cases and a lot of adult cases, there are compromises, whether that be aesthetically inclusively, but they are well aware and it’s mic my working life so much less stressful. Because of the fact that there is less mistakes, there is less excuses because of the fact that we finished at the end of the treatment and the patient says, Oh, I didn’t realise this because they knew about it in the beginning. You know, it’s like if you tell them at the beginning, it’s starting excuse in the end, you know what I mean? So that’s the way that I like to work. It’s something I enjoy working with my colleagues and finding that when they realise that they’re getting work back and they’re enjoying sending patients to me and it keeps me busy as well, so.

[00:41:19] And then there’s your marketing strategy itself, Josh. You mentioned you need to work harder on your marketing, but I think you’re actually doing it. You know, the fact that you’re treating these patients comprehensively, if I was your referring dentist, if I was referring to you and I sent a patient over and said, Look, this patient wants to align their teeth, I know you’re the guy to do it. And then it comes back with a whole bunch of restorative stuff that you’ve treatment planned. You’ve pre-sold. And then that patient lands back in my chair and I get to do that work correctly. I’ll make sure I send you more patients, right? Well, that’s yeah.

[00:41:51] And it’s I mean, you might know of the digital small design. Sure, kind of. With Christian Coachman, you know, having having really got on board with that quite early doors, even when Elaine was teaching on it back in the day when I was still an undergraduate, you know, I was really kind of hammered into me that every patient should have this ideal plan and you work backwards from that. And you know, the way that I would really love to work in the future would be to have almost educate in a way by referring dentists to be the quarterback. So, as you said, they have an understanding of all the areas of dentistry and they know what the patient needs. They are the quarterback, kind of managing everything they say, OK, so you would need a bit of orthodontics. We need some. We need this implant. And they send out. If they can’t do that work, they would send the patient to me, perhaps with a wax up that I can kind of go by. I can move the teeth within that wax up. You know, I’m working for my prescription at the moment. I’m a little bit like quarterback in the sense that the patient comes to me not knowing I work out and I say, OK, so actually, I’m going to do this part and I’m going to send you back for this work with your own dentist again. So I would love for that rule to switch and almost have the, you know, I’m almost like a pawn in the the game. But at the moment, I’m finding that I do a lot, I do a lot and I’m not doing it for personal or financial gain. I’m doing because that’s the right thing to do, and it helps me to send, you know, some work back to my dentist.

[00:43:17] You can only do that, Josh, because of your education, your background. I don’t think there’s many orthodontist who’ve done the year long. Chris, of course, done the DSD stuff and you’ve you’ve you’ve engrossed yourself in all that education. And I think in a similar way, TIFF’s argument always revolves around as GDPs. We should be well-rounded, right? We should be engrossed in ourselves in education that revolves around at least being able to do G.D.P. also and understand where our limitations are. Yeah, yeah. Knowing what we can and can’t do. But moving on from there, Josh, obviously you found yourself now having, you know, working in these practises, you know, treating patients, doing a bit of ortho restorative dentistry as probably termit. And how did you break into the scene of teaching? Because for me, this young and you know, there was absolutely no way that I thought you were a specialist because you look far too young to be a specialist, right? And so all

[00:44:17] The degrees are showing what kind of haircut to kind of get rid of them.

[00:44:20] At least you’ve still got some hair, mate. But this young kid breaks onto the scene and you see him all over social media teaching, and you certainly caught our eye. How did you first get into teaching? Was it that influenced from back right at the beginning or yeah,

[00:44:38] I would say so. It was never something that’s come natural to me, and I still do get nervous when I’m talking. I would say that before lockdown, I did do a lot of work with the BCD on like a Saturday morning. If they had an event on a kind of a regional meeting, let’s just say or a study club, I’d be involved in that. I might speak at things like that. After and during lockdown. I got into webinars, as I’m sure we all know. I think we’re all webinar about. And and I guess my my main drive and I don’t know if it’s a selfish thing or not, but my main drive for lecturing isn’t so much, you know, from a financial point of view, it is very much that by lecturing and teaching, you know you do one, so you watch one, do one and teach one. It’s helping me understand. My case is more you spend the time kind of critiquing yourself more and you look and you see sometimes the mistakes that you wouldn’t have seen by looking back and kind of building your slides and things of that. So in a way, I kind of do it for myself in, you know, helping me kind of get better what I do. I also do it in a way, and lockdowns kind of put a bit of a halt on that. But you know, I I want to be able to see a bit of the world and lecturing it can be a very lonely.

[00:45:51] Place, you know, in your four walls and your surgery. I don’t want to just lock myself in my surgery, I want to get out and see the world and lecturing gives you an opportunity to do that as well. Going to conferences, meeting people as well. So in a way, from a selfish point of view, that that’s why I do lecturing for my own gain from that perspective. But I really do enjoy, you know, helping others. I mentor a lot of dentists, but only with a line of treatment and looking at their orthodontic setups, their clinics and just, I guess, in the position that I’m at being a dentist who receive referrals, you know, I help out my colleagues and doing and doing what they do. You know, I’m more than happy for for them to tackle difficult cases that they may have otherwise referred to myself to do. But with my help, they can do it themselves and their own practise because they have the reputation and they’ve got the relationship with that patient, you know? So yeah, I do a lot of mentoring. I get a lot from the fact that actually, you know, those that I teach, I like to think I inspire them and I’m making their lives better or easier. I should say I’m helping them not make the mistakes, perhaps that I made and everyone wins.

[00:46:59] So how did you break into it? Was it a conscious thing that I want to become a lecturer? You know, something that we asked people who sort of speak their, you know, how did that journey happen? You know, a bit like your journey into dentistry. The 14 year old kid who went for work experience and then was treated by Elaine Halley as a younger kid and all the rest of it, and then ended up, you know, connecting the dots. Was there any particular moments or events that triggered and inspired you to get into sharing your knowledge?

[00:47:27] Sure. If it was like a particular event which kind of kicked it off in the sense that, as you said, I have, I have invested a lot of time and money into training and early, and I kind of wanted to get under my belt and and I guess because of the fact I’ve done all this education, people wanted to know if people wanted to be like, you know, know, so what? What do you know? And so I guess I got invited to do smaller things, you know, just an hour here or there webinar. I, you know, I was very grateful for for TIFF and Rossin yourself kind of kind of opening the door within the Ice Academy. I mean, that’s almost like the biggest thing for me actually now. Up until that point where I came down and did the full days course on aligners, I had never really done a full day before, actually. All right. I had actually I’d done a deal with the Backhed actually once before, but mostly smaller power here and there, or or webinars. And it’s just kind of a bit snowballed quite quickly, actually. And thinking about it now, because I has really just been just before and during lockdown that I would call myself someone who does lecture. And yeah, I’m just kind of reminiscing here thinking it’s been quite fast.

[00:48:34] And there’s something really been about two years, and I’ve come a long way in that in that time where I think it will go. I mean, I’m quite comfortable with where I am now with it. I don’t know how much further I can take it, but certainly, I mean, I certainly with the Ice Academy, you know, it’s great to get the feedback from the delegates who’ve been on their early courses and are hoping to inspire, you know, those just like in practise, you know, patient self referrals, you know, Dental referrals say, I went on this course, I learnt a lot. And you know, when I get more people through the courses and help them kind of understand my way of, you know, tackling a minor cases, a slight change in mindset when it comes to orthodontics as well. So that’s where I kind of want to take it. I’ve got no aspirations of being a keynote speaker at, you know, the American Orthodontic Society Congress. I’m not that level and I probably will never be because I think the next thing I need to do is not so much CPD and Dental related things. It’s probably more about marketing and lecturing, actually. So that’s probably where my next videos will go.

[00:49:37] Funnily enough, Josh, you say you don’t want to be that guy and, you know, whatever. There’s so many barriers in the way, but it sounds like listening to your back story from, you know, these moments of, you know, connecting the dots with various people, mentored people who have inspired you. You’ve just you’ve just hopped from one to the other. And I think a little bit of work, but a little obviously a little bit of luck, but I think you create your own luck. Yeah, Josh, you really create your own look. And I think, you know, taking up opportunities like, you know, running this course and whatnot puts you in front of people, right? And, you know, meeting the right people, meeting the right people. And so with the next question I actually had for you was related to the clearer line, of course, or courses that you run in at the academy. And you know, I think I already know the answer to this question now because I know about your background. But what’s the difference between coming on a clearer line aligner course that say Josh teaches versus, you know, the standard, let’s say, Invisalign course or, you know, whatever all these on the clear line of courses are. And for me now, like my one, take away from this is you are a dentist and an. Orthodontist and everyone said that everyone is an orthodontist, is a dentist, but for me, you’re a practising dentist, and when you teach these GDPs, you do in the restorative stuff, you’re thinking about the occlusion and all of that, and

[00:51:05] You’re not just orthodontist second.

[00:51:08] Yeah. And it doesn’t seem like you just right. I’m just shifting these teeth from here to and I’ll show you how to do it and all the mechanics and whatnot behind it. So just talk me through your approach. I’m I’m a clear correct user, a sure smile user in Invisalign user, a smile and user. You know, I’ve used a whole range of clearer liners. And you know, the whole premise of your course is it’s purely Open-Source, right?

[00:51:30] So yeah, it does not understanding the tools, really. That’s what it is. Sorry to jump in there. Go for it. What is the difference? Yeah. And having having done initially the Invisalign course, see fast. A lot of these kind of bracket them as almost like weekend courses that you would do. It is very much to learn a system in the sense that there is a black box in the middle there that isn’t top because you cannot always teach someone how to get into C Invisalign or sure, smile in a day. And so it’s almost like this idea of, you know, teach people how to put the records in to get the aligners out and maybe go over a little bit more about the practicalities of things like fitting attachments, what IPR is, but you’re not really having spending the time to learn intricacies of how the mechanics work, how the teeth actually move. And you know, that’s that’s the biggest thing for me. And I guess I like to think that when going on a course with myself where I have that experience of using multiple different systems and knowing what I gathered from these courses before, yes, I learnt certain things, but I didn’t really understand what was underneath. And I guess with the certainly the clear aligner level courses run by the U.S. Academy, and I like to think that I just kind of delve deeper and I open that black box.

[00:52:47] I help people understand how the teeth actually move, what movements would work, what don’t. So it’s not just a case of get your set up back or you’re clench it back and saying, OK, the teeth have moved. I like that. Look, let’s go for this to prove it. And someone told me what it was like. 90 percent of all Invisalign cases get approved on their first clean check, but you’ve got to remember that the technicians on the other side, they’re not always dentists and orthodontists. They they are, you know, guys that are very good or girls that are very good at a computer game. In a sense, you know, yes, they have parameters to work from, and the artificial intelligence within their software works very well. Yeah, but it is not the be all and end all, you know, and there is there is mistakes that are made and it’s about understanding how to combat these difficulties and tooth movement with aligners having an understanding not just about aligners, but also just how teeth move in general with braces as well. It is all much of a muchness and you know, when I always say to people, you know, teeth are stupid, you know, if you pushed on them for hard enough and for long enough, they will move.

[00:53:49] They don’t know if they’re being moved by a bit of plastic or a bit of wire, you know, so it’s trying to just take away from this mindset of, you know, I’m only an Invisalign provider. That’s all I can provide. And a bit like the dentistry, you know, having an opening the floor to actually a greater depth of understanding. But what would be best? You know, what tool is best for the job here? And that’s the way you describe it. When patients come in and and request a treatment, I say to them, I you what you’re paying for here isn’t the white braces, the aligners. It is the end result, the tools, the brace. It’s just a tool that I use to get you there, you know, and and the pathway might not be straight. It might be a bit windy. We’re having difficulty moving teeth. We might have to go back to the drawing board and make more aligners. We might have to change things. It’s a learning curve, but the beauty of orthodontics is it allows you to navigate through that path. And if things don’t go the way you had initially planned, teeth might move differently. Then you can always move things back usually. So again, that’s I like to think that this is quite a safe profession.

[00:54:49] Go go. Going into that black box that you spoke about earlier, that opening that black box for four GDP’s and passing your knowledge on, you know, the whole concept of the black box thinking theory is that as health care professionals, we rarely share our mistakes with the community. But the airline industry by default has to go through that black box. Any mistakes that are made are shared industrywide, and that’s why it’s such a safe mode of transport because we’re all learning industry wide from the mistakes. So if you could share some mistakes that you’ve made either your biggest clinical mistake or just during your time of practise in what mistakes have you made that maybe our audience could learn from?

[00:55:31] Yeah, I mean, I know that before this, we had a bit of a brief chat, and I’m actually going to bring up two facts. Okay? One is very much clinical, which I’ll probably go into after. But the first one, I think probably the biggest mistake in my career was just about how I communicated, I think, with my patients. And, you know, I was young. I was eager I wanted to do the treatment, and I was going about my second consultation, sometimes all wrong, where I was very much using Dental lingo and I would talk to the patient as if they knew what I knew and it was and it was. Looking back, it was wrong, and it’s off-putting actually as a patient being almost talked to. And one of the biggest things that I’ve learnt in my career is, you know, just learning to listen to the patients and let them do the talking. A second consultation, I think, should be 80 percent them talking and 20 percent. You actually, you know, get them off and get them to understand what they want. Almost make let them have these light bulb moments. And then they say, Joshua, I want this, you know, before you’ve even talked about pricing and things.

[00:56:35] And so for me, one of the biggest mistakes in my career was just about how the patient journey went and how I communicated with the patients. You know, you’re, you know, more more than most how important that is. And so I probably did myself a disservice early on in my career where I could have had a much better case acceptance and done more dentistry when actually I might have sometimes been a bit off putting. And patients are a bit overwhelmed by some of the terminology and some of the things I’m presenting to them. So but it is a learning curve, and I suppose some people might see it as a mistake. Some people might see it as it was just your development. You know, everyone is never going to be the magical person in the very beginning. But but I look back on that and think, Yeah, you know, it wasn’t as good as I could have been. And then, but yes, so you can talk a bit about that if you want to.

[00:57:20] Was there was there a course that you went on or a light bulb moment or somebody that you shadowed at a certain point in time where it just clicked and thought, Crikey, this is how I should be speaking to patients? Well, did it just evolve?

[00:57:32] Yeah, I would say that actually going on the digital smile design courses where they they do focus a lot on the patient experience and the patient journey. They helped me, I suppose, understand a little bit more from the patient’s perspective because you’ve got to understand that they don’t know what you know. And I was too busy focussing on the the problems, I suppose, or the the facts when actually it’s what what patients want to hear is solutions and not sometimes the solutions to what they initially have in their mouth. But but then the benefits that it brings to them with the dentistry, you know, talking about more about the confidence that will bring, you know, because like, for instance, I had a patient last week who’s getting married in six months. And yes, you know, I talk about how the treatment will go through. I’ll talk about how the teeth will move, but then they’re not investing, that they’re not investing in, you know, just that treatment. They’re investing in the confidence that bring them in their wedding photographs, for example, there’s a there’s a deeper level of understanding in a way always is that that’s it. And it’s it’s about bringing it back to that root cause of why they want to have it done. It was almost a little bit of for myself how I got to that stage where I guess I’m more aware of that now. It was almost just threw a bit of trial and error mistakes. Kind of navigating through that consultation with the patients and getting to know them. I have done a lot of work in a way with kind of with Dental sales training and in a way in marketing to patients. And it’s just been an amalgamation of think of of all of that, can I come together that I guess it would have been a bit of a light bulb moment at some point? I don’t know when that was, but I do feel like what I’m doing now is working for me. But yeah,

[00:59:11] Before we go into your second mistake, Josh, take me through your your patient journey. Me as a patient comes in to see you with that problem. Let’s say this gap in my tooth that’s been that’s been getting bigger and bigger over the years. What’s the tell me about the journey I come in? I see you. What’s the investment to come and see you and have an assessment? All the rest? Just take me through that A2Z journey because I know it’s completely different for everyone, even though we sit in our isolated four walls and think everyone does it like this. So just share that with us, please.

[00:59:42] I mean, it all starts before the patient is really even coming to the practise. It starts by your presence online. It starts with the emails, the communication that you send to the patient and, you know, trying to make them feel while one confident and coming to see you like sharing with them, your experience, your reputation so that when they come in, they’re already that you’ve set the bar for success almost before they’ve come in. But certainly, you know, in terms of the in the practise, it’s they would use a patient would come in. It would usually be a 15 or 20 minute point with the treatment coordinator or myself to just get an understanding of what they’re wanting from the treatment. They would then come in to see myself again to just elaborate a bit more, you know, ever meet and greets to work out what their concerns are, what their expectations are in a way. You know, what is it they’re wanting from the treatment we run through our clinical exam, we gather the records sometimes when the first visit or if the actual discussion is taking a bit longer because it’s really important to sit down and chat with your patients and can’t emphasise that enough actually, to all younger dentists, just take the time to talk. Actually, we’re two to. Focussed on just rushing in there and having a look, you know, just chat to people. And if we can, we would take records at that first visit, which would usually be filled with records. It could be x rays might even be 3D x rays sometimes and orthodontics as well now. Scans of the patient’s teeth and photographs.

[01:01:06] We would then let the patients head off, and the investment for that first consultation is usually just £200. Mm hmm. Because I don’t want to make the finances become a barrier to, you know, allowing me to present a plan to a patient so I don’t charge the world to to for my time. My initial consultation and I would then gather the information and I would either lock in sometime during my clinical week where I would do treatment planning letter, writing things like that, or I would actually just do that work at home. Know, I’ve got some cases I’m going to be going through probably later on this afternoon and and I sit down behind the scenes and I and I plan what I’m going to do, how I’m going to present that to the patient. And I actually use almost like presenting a slideshow. I use keynote. I put the patient’s photographs on the presentation. I might annotate those photographs using my iPad. I draw a line. I arrow and I say the key here. Or, you know, there’s there’s a problem here. So it helps them visualise it because they look at an x ray and you point to something and they see a black and white mark. They sometimes know what that means, but if you cannot test it, then great. And then during a second consultation, I sit down and I book about half an hour for a second chat and we run through it. We might get up Invisalign or a smile tooth movement simulation as well, so they’re visually seeing what it is that people look like. I also have the ability to then take that and then do a bit of a restorative work.

[01:02:28] So I might say to the patient, after we’ve moved your teeth, you can see that actually, it is highlighted more where there’s it’s where before your teeth was rotated, when you turn it, you can actually see there’s a bit of a chip off that tooth you might not have been aware of. And then we can actually have those discussions at that second consultation about the restorative part to to follow the orthodontics, you know, almost that day one. And so the patient has a lot better understanding of what they might need. And, you know, hopefully, you know, because I’ve shared the time and you know, we’ve invested in them that they are more likely to see, you know, Josh. Let’s go for it or if now isn’t the time. And I very much I do highlight to the patient, actually, there is no rush. You know, we could wait some time. It has to be the right time for them. More often than not, they will come back because they will be confident and the work that you’ve done, and even if they do a bit of shopping around, there will be no experience, hopefully like the one that we’ve given them and they’ll say, Well, actually, you know, I want to go and see just because I, you know, I jelled with him. So and that’s how the patient experience goes and the journey through the clinics that I work in. And then after we do, we get the acceptance and the patient goes to the treatment just as anyone would so. So, yeah, that’s how we did it.

[01:03:36] It sounds like you’ve got that process buttoned down. So in summary, the patient will come in, maybe see the TCO for 10 15 minutes. They build up a bit of rapport with that with that patient. And I’d almost like to sell you right the concept of having that full assessment with you.

[01:03:52] It kind of makes me cringe a little bit.

[01:03:53] But you know, that’s what it is, right? They settle the concept of your expertise, the you’re the right man for the job. They come in and you spend a lot of time chatting to them, getting to know them, do a comprehensive assessment and then invite them back for a second consultation where you presenting almost like a keynote presentation with their photographs and stuff.

[01:04:14] Yeah, wow. Yeah. And I’ve got templates that I use, which makes that work a bit easier to drag and drop them. We have members of staff that we’ve trained to do things like that as well. So it’s a it took a while to get a nice, streamlined way of doing. It seems to be working quite well now. You know, everyone’s playing their part, which is great. And yet it is like presenting it every time a patient comes in. But the beauty about that is along with and I don’t usually write very long and drawn out treatment plan letters explaining all the risks and benefits. So so what we do is I then get that keynote put into a PDF and send up to the patient. They have their actuaries have their photographs annotated. They’ve given that all information. So actually they are they are much more aware than if I’ve just kind of talked them through it as if they’re just sitting in a chair and then said, here’s the bit of paper sign at the bottom. You know, I know that from a professional point of view, we do have to get the sign on the dotted line, which we still do. But realistically, no one reads the T’s and sees no no giving them the photographs. They’re going to go home, they’re going to look at it. They’re going to show their friends, look how much effort, you know, this dentist has made and to help me helping me understand what my smile can become. And yeah, it’s not the right time for them to start now. I can guarantee they’ll be back within the next year because they’ll they’ll have that on their phone and they’ll, you know, every time they think I’m a tooth and then they’ll look at their photographs and they’ll see the kind of smile design that we’ve done for them and think that does look good. So, yeah, it’s the way that I would want to be treated, you know, never, never treat someone like yourself.

[01:05:39] Yeah, it’s funny, Josh. Earlier on, you were talking about, you know, you need to help your sales and marketing game. I think I think we could all learn quite a lot from from just your process that you’ve shared there. Because you know what you’re sending them out there is with a full blown personalised brochure of them for them, right? Instead of handing over, well, this is what Invisalign does, but this is what your smile does are clear, correct or whatever.

[01:06:05] Yeah, it’s encompassed everything, really. And I don’t ring fence the patients in the beginning. I actually don’t give too much away in that first visit in the sense that I might give a bit of a hint to say, Have you like, have you considered moving your teeth or have you considered doing a bit of whitening or reshaping? I generally don’t really give away too much in the way of a price in the first visit either, because I say to the patient, if I was going to go for scans at at the hospital, you know, I wouldn’t expect to get a diagnosis that day one. And I do feel that as a as a dentist going through the educational pathway, you are kind of led into almost giving an answer immediately. You know, when the consultant comes around and they say, what’s going on here, what you’re doing and say, Oh, this patient has this, this, this, you know, they have a beeper of three here, you know, you know, you don’t you don’t need to to rush, you know, take your time. And it makes for a much more comfortable working environment, for sure.

[01:06:53] And you get them in to present your treatment plan to them, right? She got them back in.

[01:06:58] I do, yeah, I like that personal, and I know that with COVID and things at the moment, you know, people are doing things a lot more virtually. And yes, I have done second consultations virtually, usually for patients that are further away. They might not travel in for a chat and you can do that. And by getting the presentations ready like I would do anyway, it’s very easy to share. It was actually had dinner last night with a dentist to a group of dentists, ultimate implants or do a lot of implants. And they were saying that they do struggle to do zoom consultations because it’s very difficult to sell, but it’s quite an expensive treatment just by saying I can replace that tooth, you know, whereas you know, with orthodontics, you have the ability to show them a clincher. You have the ability to show them maybe before and after. It’s very difficult to do that with with implants. So. And so they’re finding they’re struggling a little bit with that, whereas I actually have embraced it and I quite like doing it. But I do like the personal touch. I like inviting people in and taking that time. But if they travel or they find it difficult, we will organise it and we’ll do it that way as well.

[01:07:56] Yeah, yeah, it’s surprising how many dentists and I’m sure a lot of listening to this they’ll may have. Maybe having a light bulb moment is they just email the treatment plan and then wait for the reply

[01:08:07] And you’ll be waiting a long time to be waiting. Personally, and I think I think you might have heard me say that, you know, as human beings, we never we never buy things rationally. We will never buy things emotionally. If you buy a new car, you’re not buying a car because you want to be going to work in this car. You foresee yourself sitting in the nice seats. You’re you’re envisaging what others see of you sitting in that car. It’s an emotional response. So you’re not buying it for the practicalities of getting from A to B because you could go and buy a scooter. You know, if you if that’s what you’re after. Yes. So you know, it’s a very, very not the best terminology in terms of describing that. But hopefully you understand what I mean.

[01:08:45] No, absolutely. So. Moving on to your second clinical mistake or mistake that you. What? What what’s that, Josh?

[01:08:53] I guess my mindset has slightly changed, actually, in terms of where the biological boundaries lie with orthodontics. So as an example, I had a case where and the patient came in. They were a Class two Division One Dental relationship, and the patient wasn’t interested in doing any surgery. So we knew that we were going down the road of camouflaging this, and so we decided to take out our proprie molars very commonly done. But my mindset has shifted now because in that case, we took out the teeth, we lined up the teeth and we thought, OK, so everything’s looking pretty nice and we’ve got quite nice occlusion. But I’ve got these huge spaces to try and close and it takes a long time, especially in an adult. So clinical mistake number two was that, you know, we we’ve taken our teeth in some patients that maybe ought to maybe not have teeth. You know, we could have treated this patient in a different way, and the patient’s treatment time could have been maybe half that could have taken maybe a year as opposed to two or longer. And yeah, and now I am more of the of the mindset that actually I would perhaps do a bit of alignment. First of all, for those that you know, I’m thinking in the beginning, well, we could be taking teeth out here.

[01:10:01] But if the biology allows for it and I’m not going to expand or I’m not going to cause any recession or distance from doing that, then I’d be much more inclined to actually line up teeth first, reassess after that alignment phase and then decide at that point, but the patient would be consented to the potential need for extractions later on. So sometimes, though, we’re just kind of saying no, now we need extractions. This it’s a case of, you know, we’ll let things work out a little bit first and then we’ll decide. But also actually and kind of just slightly branching off from that. The integration now with 3D rays or combine x rays with an orthodontics where you can visualise the roots within the bone and things like that. And you kind of it’s a bit of a mind shift from me actually understanding where the biology is and understanding how much we can expand, how much we can proclaim teeth. And so now I think compared to myself last year, we were always learning. I am more inclined now to maybe do extractions sometimes or doing a bit more IPR between the teeth because I look back to the case and I think, well, actually, I might have pushed some of those routes out of the bone and I might have cost them recession there.

[01:11:05] So as technology advances, as I had developed and as everyone develops as an individual, you’ll look back on case you did last year and think, what was I doing? Why did I do it that way? Yeah, your whole career, you’re evaluating things you’ve done. And so I guess that’s mistakes that I’ve made in the past where it might have been a bit gung ho with extractions and it’s almost come full circle again now where? And it’s like that in orthodontic as well. We were very pro extraction. We’re very not extraction and we’re kind of coming to terms with a bit more extraction now. It’s going round and round in circles. Same in my own short career so far. I’ve kind of gone both ways and and learning from the mistakes. So yeah, that would be my second mistake that for any individuals who are planning to do cases whereby they’re they’re thinking and they’re planning to decide to take teeth out. Think to yourself, can I maybe line this up? Does the biology allow for it? And if it does, then consider me, Blaine, first of all. It might save a lot of time later on. Yeah, in terms of, you know, maybe I didn’t have to do that.

[01:12:01] Yeah, yeah. And and then moving on, you talked about, you know, the technology in our game massively improved and given us access to see things visually do things visually, the whole clean check or the equivalent thereof of these two simulation movements. And along with that, you know, has come direct to consumer orthodontic. So you rock up in your local shopping centre, get scanned by a non Dental professional and pick up your reminders and do it yourself. Just give me your thoughts on a direct to consumer orthodontics and be have you had conversations with patients about direct to consumer orthodontics and what’s the narrative of that conversation that you have with them when they ask your opinion?

[01:12:50] So I mean, great. Great question, and I’m sure you get a lot of different responses from a lot of different dentists regarding that. My overall view is that it is and I know you might be a bit shocked by this, but it’s probably a little bit good for our industry, actually, that they’re there. And I do think that they have brought a lot of awareness within the general public about orthodontics and about aligners. I would actually argue that I’ve had more patients come through my door because of the adverts that people see on the TV. So I am not anti direct to consumer aligning because I think actually it does suit some patients. Actually, you know, for those patients that have had orthodontics as a child, they’ve lost their retainer. One tooth is a little bit out of alignment. They’re actually, you know, why sometimes are you paying for my services when sometimes actually it could be dealt with with a couple of aligners and and things? And so you can save money there if that’s what the patient wants. The bit that gets me really is the fact that there is no clinical exam sometimes, and there’s a risk it is very much a risk. And you mentioned about the question two there about, you know, have I had chats with patients and I’ve had patients that have had SmileDirectClub and then come to see me because they only got a little bit of the way there.

[01:14:08] So because you haven’t had an orthodontist riding on their back and because it is not as expensive, there may be a little bit less likely to wear them as well. And my experience of these liners is that no one ever gets to the end result that they want, but they may get 80 percent of the way there that might make them happy enough. So it serves a purpose, but it is not comprehensive treatment by any way. And I’ve seen patients that have had that, and they want that little bit more to come and see me, and I finished the job off, actually. But on the other end of that scale, I’ve also seen cases and one particularly brink comes to mind. A new patient consultation just found us through the website, essentially, sure, women with a bit of paper essentially wanting signed off for. And it was SmileDirectClub, and they came to me and I was a bit shocked. I was like, Well, we want to. I had never heard of them before, and the patient came in and I just sort of feel orthodontic exam. They were a class three, quite heavy crowding, very bad peril caries in the teeth and a and I thought to myself this this patient is borderline orthographic surgery patient. And at the very least, they need to be taken out to a line. They see there is no way that these teeth can be lined up.

[01:15:17] Now, I don’t know what the SmileDirectClub Plan would have been, but they wanted me to essentially sign off this patient as being fit for orthodontic. And I said, I cannot do this. And if I give you one take home message, here it is, you know, don’t do that. You know, I would happily give you this treatment at cost price because I worry for you. I don’t need to go down the road of doing this and please understand that you need teeth out. You know, you might actually consider doing jaw surgery to get your jaw in the right position and get your teeth straight here. And so that concerned me a little bit. While I say a little bit a lot actually, that I worry about patients that might have this kind of work done that have got active disease and it might be leading to problems. And we’ll never hear of these problems because it’ll probably get squashed a certain level in the legal term. They’re a big company. I’m sure they can squash these things by giving money back and giving away things. I’m sure they keep the patients happy in the end, but I think of an overall perspective. I think that direct to consumer lighting has a place, but the fact that there is not a clinical exam, sometimes it kind of worries me is the take home message from that.

[01:16:26] It’s an interesting take on it, Josh. And I think, you know, I can sit back now and just listen to your perspective and I can see I can see how it’s been beneficial to our industry because it’s created more awareness, right? And it ends up creating more work for us. And I think my concern around it just revolves around even if that patient just needs one. So we’ve shifted. Do they have the knowledge to make that decision that direct to consumer orthodontist is right for me? That’s my story.

[01:16:54] No, no, I agree. I. Surely it’s a very tough question, actually, isn’t it, because patients don’t know what they don’t know and they just assume teeth move and and things and and yet am, I’m sure, out there there’s a lot of patients that wish they hadn’t done it because they probably call themselves more harm than good. But it serves a place, but I think the overall it has not taken away patients from our chair. I do think it has actually put more bums on seats, actually. But yeah, there are patients that are being treated that that are entering into a risky situation. Yeah, absolutely. They don’t have all the information, they don’t have the X-rays. And sometimes what I worry and I’ve had to chat to patients before is that if they’ve had other people before, you know, we don’t always take X-rays because we wanted to see how this has any decay or how the gums are. But actually, orthodontics causes resorption. And if a patient has had two, sometimes three years of quite hefty orthodontics, their roots might be a bit shorter, and that can cause problems that they wouldn’t be aware of if they were to go down the road of orthodontics without having that information first. So again, there’s a lot of pitfalls with direct-to-consumer lining, and I wouldn’t say that I tell. I would never say to a patient, go and have accepted it, you know what I mean? I would go and do it, but I like to just educate people and patients on.

[01:18:11] So just on on another topic very similar to that, that we that we asked a lot of dentists. And I may not necessarily ask this question to a traditional orthodontist, but I’m going to ask you, OK, which is cosmetic dentistry abroad, which we often refer to as turkey teeth. What is your advice to someone that comes and asks you about that? And also, what’s your opinion on it?

[01:18:34] Yeah, I would say I’m quite liberal about it. As long as the patient understand what they’re what they’re getting into, it’s it’s OK. I like to. I think that I’m a minimally invasive dentist and the line bleach and bonds way of thinking that I try and conserve as much enamel infrastructure as I can. If I can move the teeth and just add to them, then that is better than drilling them down, for sure. But you have to remember that with orthodontics also comes a contract of lifetime retention as well. And some patients, they might not want to wear retainers. They, you know, they aren’t. They say to me, Well, actually, Josh, I don’t want to wear these retainers for life long. So actually, I might go down the route of veneers and and it’s easy to the room. And as long as the patient is educated that once you go veneers, you cannot go back. If they’re understanding that, then that is their decision to make. I would honestly say that my Dental hat on here that as my career has progressed and as I have done a lot more cases with porcelain and composite and understanding occlusion that actually I was maybe too minimal in the beginning, actually with a veneer prepped and things like that. Now I’m probably a little bit more. I wouldn’t say the word aggressive, but certainly I’m much more aware of, you know, sometimes veneers that need a little bit more a grip in a way, and that’s relying so much on the adhesion and the bonding, and more so that I actually want the veneers to just have a little bit more of a wraparound effect.

[01:19:58] So I would actually say in the last couple of years, my veneers prepping has become a bit heavier. Actually, I don’t know if many would agree with that, but but from that perspective, you know, that’s it’s my learning curve. But going back to your original question about the turkey teeth, my own barber, I just because I had a haircut yesterday it in from my mind, but he told me he had booked in to go to. I can’t remember the Seville Smile Club and it is in Turkey. I’m pretty sure to have his teeth then. And I said to him, You know, David, let me do it, please, you know, because if you’re going abroad, you have the risks of having it done all in one week and that something might go wrong. And and if everything goes wrong in your home, you’ve got to fly over there and have it fixed. And there can be a lot of pitfalls financially to having that done. But let me do it, and I even said to him, I will match their quote money wise. You know, I will. I will take the money perspective out of this and just let me do it for you, please, because you know, I wanted, you know, and I wanted to do it for him, actually. He still turned me down. Anyone over there had it done because actually people sometimes want the well they’ve been to Turkey as well. So for him, he wanted that look and it is a little bit of this awesome how he turned down the offer. And and funnily enough, I’m now fixing one of those videos for him, and

[01:21:08] He’s fully

[01:21:08] Paying. Funnily enough, he’s paying half the price that he paid before to have one or two repaired. But yeah, again, you’re asking some tough questions to do. I like it there. I imagine there are some very good dentists abroad that do this work, and if you pick the right clinic, then you’ll get very good work done, if not something better than some of the work that I’ve done here. But there are pitfalls like the travel, the expense, things like that if things go wrong.

[01:21:36] Really interesting perspective there, Josh. From your barber is that actually, you know, he had he had the possibility of and obviously having listened to about you, about all your training and education and all the rest of it out of reach, hand off rather than rather than flying over to Turkey. But I think

[01:21:52] People, people want

[01:21:53] The holiday, right?

[01:21:56] He wanted the holiday, actually. You’re right, you wanted the holiday. You got picked up in the hotel was part of his cost of his treatment of things. And some people want the fact that they’ve been abroad to have their teeth done. They want to be able to tell it to their friends. And and I know it’s a hole to our conversation in itself, but you know, the appearance, how appearances have changed without our awareness of celebrity social media and things. And I am well aware that people want the I wouldn’t the term by someone who uses the false look or the veneer. The look in a way. But a lot of the time when I when I sit down with patients, I say that that’s not what I go for. If you come to see me, I would much rather give you a natural aesthetic, one in which where if you’re having a bit of work done, I almost want it that when you go away, your friends, colleagues say, you know what’s different about you? Something something’s changed. Something’s improved. Something’s, you know, you look nicer. You look more confident. I don’t want them to be like, Oh, you better treat them, you know, because yeah, it’s almost a in my opinion, because I have made it too obvious. That’s the jargon that I use with my patients, and I let them sit there and they’re nodding like, Yeah, no, you’re the one for me because and people don’t want that. And I have turned down treatment in the past where someone has said, I want to come in and have veneers, and I said, I’m not prepping those teeth, actually. And I and I don’t know where they are now, but I don’t refused to do it because they were about 23 and I was like, You’ve got your whole life. You’re not going to have any teeth left by the time you’re in your 50s.

[01:23:20] Yeah, yeah, absolutely.

[01:23:21] I do refuse. Sometimes if someone is wanting that kind of appearance, it’s not something that I really want to want to go for it in my practise and career. Sure. And I understand it’s a big work and I might be missing a trick by not doing it. But, but, but no, I think that there are there are places in which people can have that done.

[01:23:41] I think we all have our own values in our own standards. And that’s not to say that your values and your standards are any better than anyone else’s or vice versa. Right. It’s just it’s just your philosophy and what you believe in.

[01:23:53] It’s also where you work and things as well, kind of how you marketed your practise. Have a lot of respect for a lot of these very good dentists. You know that we see these kind of celebrity dentists. They’re very good at what they do, and they have just marketed themselves so that that clientele. It’s just not the clientele that I you deal with. So it’s everyone’s different, really.

[01:24:11] Yeah. You serve a particular audience and they tend to want a particular thing that you do very well. And then there’s another group of patients who are probably better served by someone else because they’re not your audience, right?

[01:24:25] And I was gonna say, going back a little bit about the turkey teeth in terms of the prepping of them, yeah, that’s kind of where my ethics lie in terms of their age, how restored their teeth are. There’s so many factors at play that actually, it’s hard to answer that question in the sense that, yes, I wouldn’t I wouldn’t go, you know, just blindly in with the BR and prep the teeth. But there are some patients that have had very heavily restored teeth that do require that at the same time.

[01:24:49] So yeah, just this brings me on to you. Haven’t listened to this podcast? You don’t know what’s coming next. So if you think the questions have been a little bit tough so far, we’re going to finish off with a couple of sort of questions. But these are not not dentistry. You have another coffee. Not necessarily dentistry. So we always like to finish off the podcast with a couple of questions, and one of them is if it was your last day on the planet. She’s OK. And you were surrounded by your loved ones or your future loved ones, whoever they are. And you had to give them three pieces of life advice or wisdom.

[01:25:37] What would they be? Three. I was going to say I’m struggling to come up with one, but three as oppose. The first one would probably just be three others as you would like to treat yourself. And that comes from a personal or, you know, practising life as well as, you know, just the way that you would want to be treated. And that is that’s probably the first one, I would say. I don’t really know if this is advice, but I would say that it’s OK to make mistakes because we learn from mistakes. And I’m very kind of kinetic learner whereby if I listen to something in a lecture, I sometimes don’t pick up as much as I would like to. But if I’ve done it and I’m doing it hands on, I remember it. And so I would say, and if you make the mistakes you learn from them and you can critique yourself as well, embrace them so that that would be maybe my second bit of advice, I suppose, is, you know, just saying it’s okay to make the mistakes, learn from them, carry on. And and hopefully they haven’t been too hard hitting mistakes financially or anything else. But you move on from their third bit of advice just out of interest. What have others said for these questions?

[01:26:48] I think, you know, a lot of others just focus on that. Let’s, you know, and I guess it comes down to the way you live your lives. If you think about right, I’m Josh and this is how I go about my week. Yeah, well, my life is, you know, what is important to me, you know, children, this, that and the other, what would you what would you say to your son, your daughter? You know, when you’re passing on some knowledge and you saying, Listen, son, make sure you go out there and do X, Y and Z and don’t don’t be a knob because no one, you understand what I mean. It’s.

[01:27:24] I mean, just from what you’ve said there, actually, and in terms of where I am in my my life and career at the moment and having just bought a flats and and things, I would say, maybe my third bit of advice is just don’t don’t sweat the small stuff, you know, don’t let small things get to you. You know, there’s there’s a bigger picture, you know, petty things just let them go. Things like that that actually, I I would say in the past, I was maybe a little bit more, you know, and maybe take these things to heart or maybe think of an example. But yeah, it’s just life’s too short. So just don’t sweat the small stuff and any little things, whether it’s financially, whether it’s a little petty arguments, things like that, just just let it go. And just kind of, yeah, yeah. And again, you’re asking me some questions that are making me kind of think almost quite deep into my own subconscious feeling. So it might not be the best advice, but that might be the three.

[01:28:25] Oh, that’s cool. It’s absolutely cool and all make sense. And Josh, so. So if that if that was your last day and someone was to make a comment that, you know, Josh was dot dot dot. Mojo, Legazpi, how would you like to be remembered?

[01:28:45] Wow. Yeah, that’s a tough one. What would my obituary say,

[01:28:53] I feel I feel like I feel like you’re too young. I feel like you’re too young to even be answering this question. We always like to just get a bit of perspective from everyone.

[01:29:04] That’s a tough question, actually. I suppose going again back around, I’d like to think that people think I was I like to share things, you know, I was a giving person that whether it comes down to, you know, sharing knowledge sharing experience just in a way kind of helping. That’s what I’d like my obituary to see, actually. You know, almost shedding a tear here, getting emotional. I suppose that’s what I would like to be remembered for is not so much for an individual thing or but just being someone who was there to help others make their life easier or to help them through experiences, things like that. Maybe it’s sorry. It’s maybe not cancer

[01:29:53] Here, Josh. It’s absolutely spot on what you

[01:29:56] Like to be remembered. You know nothing. Nothing fancy. Just Yeah.

[01:30:01] And it doesn’t have to be. You’re racking your brain try to think of some of it. But actually, you’ve just said that Josh was a very giving individual who helps others. I was actually an all around nice guy that didn’t really fall out with people, pretty much.

[01:30:15] You summed it up,

[01:30:16] And that’s pretty much what you said. And you know, we’ve had some guests who said, Is it all right to say, I don’t care, I don’t care what anyone thinks because I’m comfortable the world, you know? And so there’s been a range of, you know, different. There’s no right or wrong answers to these questions. That’s true. And the final one, which I think you’ll probably find a little bit easier if you had 30 days left and you had your health, no financial drawbacks or anything like that and all your loved ones that you could tap into, what would you spend that time doing?

[01:30:49] I mean, I would definitely kind of get away from it all. I mean, work work life. No, not not people, I should say, but in terms of like work, we get away from it all. It’s almost the same question. Obviously, if you won the lottery, what would you do in the sense that you would take your your, your friends, you take your family as much as I could treat them, you know, I would, and you would get away and just, you know, enjoy the time together. I feel like sometimes career can get in the way of relationships and and you know, if if you didn’t have that as a barrier, then you would get to know people a little bit more and build stronger relationships and things that I guess 30 days, that’s the word I would probably try and do.

[01:31:31] You wouldn’t do that last veneer case or just finish off some edge bonding.

[01:31:39] I would like to think that I wouldn’t leave people in the lurch, so I would probably put a plan in place that I would make sure that everyone was looked after. But I come back and lift the drill if I had 30 days. I think there’s priorities in those 30 days that outweigh that. I would make sure that my that no one was left in the lurch. First of all, you know, I wouldn’t want to just run away like that, you know, but certainly I would want to get away and he would go and live on a desert island for that time with your closest friends and family, for sure. And yeah, just enjoy, you know, do extreme things. I’d probably take some more risks knowing that I only have 30 days left. I would go skydiving. I’d do things like that, you know, trying to make the most of it. Sorry to bring it into it, but I suppose it almost be the same if there was ever any terminal illnesses and things. You know you’d think, Well, if I’ve been given these five years or something like that, then you know, would I pick up the drill? I would probably make sure I would finish everyone off in that initial time while I was contemplating how to use the rest of the time. Yeah. And then and I would just try and, you know, just use that time as best I could.

[01:32:43] Yeah, brilliant. Josh, thank you so much today for sharing what you’ve shared with us is going

[01:32:49] To bring it up again at the end of that conversation. But I don’t

[01:32:54] Know. It’s been great, Josh. And it’s been really interesting learning a little bit more about you, your philosophy on treatment, but also for the first time, speaking to someone who is a ortho dentist. Is this hard to put behind you as a terminology? Because I don’t see it as a without any disrespect meant Josh. I don’t see you as an orthodontist. I see you as a as a guy that’s very, very good at moving teeth, but also an all round dentist. Cosmetic dentist that takes a very realistic view.

[01:33:28] It’s kind of the way I sometimes describe it. I hybrid or a bridge the gap, sometimes between the different specialities. But yeah, really? Niche.

[01:33:37] Thanks for your time today, Josh.

[01:33:39] Oh, Prav, it’s been a pleasure chatting. It’s helped me understand a little bit more actually about what I’ve done and where I’ve come from as well, so I have very much business experience. Thank you very much for that. And yeah, if you need me to to do anything else like this, or if anyone has any questions after listening to this, more than happy for anyone to get in touch with me if there’s any information that anyone wants for me as well, and I’m happy to share anything, whether it be the slideshow that I present to patients, the templates, things like that. Just ask and you shall receive.

[01:34:10] Brilliant. Brilliant. Thanks, Josh. Thanks for your time today.

[01:34:14] 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.

[01:34:30] 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.