[00:00:00] He was a dentist, and we were talking about what we like to do, and he was just like to slap on veneers and, you know, like, that’s my my thing and I’m making loads of money at the moment. What do you like to do? And I was like, Oh, I like to modulate microbiomes. And he was like, Where’s the money at that? And that is a problem. I mean, it is expensive for me in the sense that we have to do microbiome testing and we have to do some of this.

[00:00:26] Definitely money.

[00:00:27] There is, but it’s

[00:00:29] There’s no doubt about

[00:00:30] That. We need to work on. I mean, at the end of the day, it’s never going to be the same as doing a smile makeover. And that’s the problem and also with the microbiome because it’s non shedding and because it’s essentially quite stagnant. Once you get the bad bacteria out, that patient could be actually good for the rest of their lives. They might just need some modulating treatment for like six months and then they’re good.

[00:00:55] This is Dental Leaders, the podcast where you get to go one on one

[00:01:01] With emerging leaders in dentistry. Your hosts

[00:01:08] Payman Langroudi and Prav Solanki

[00:01:12] Gives me great pleasure to welcome two sisters onto the podcast. We’ve had lots of different family combinations, but I don’t think we’ve had two sister dentists on the podcast. Ariane and Victoria Samson. You couldn’t look them up on Instagram as the Dental sisters. That’s correct, isn’t it? That third Dental sisters and interesting? I’ve known these guys for a long time, but both have lots of interesting stories as far as their career go. Guys, welcome to the show.

[00:01:40] Thank you so much for having us.

[00:01:41] Thank you. It’s very exciting to be here.

[00:01:44] This would normally start with the sort of the back story. Where were you born? How did you grow up? What kind of kids were you? Who’s older? You guys twins? It was a story. Yeah, your twins are.

[00:01:57] You’re going to have to guess.

[00:01:58] Are you twins?

[00:01:59] No, but a lot of people think that a lot of

[00:02:01] People think that, oh, I see. Ok, I’d say Victoria’s all. Oh my God, I’m going to leave the podcast now. I’m done

[00:02:09] Already. I mean, the podcast is going to be being you now.

[00:02:13] Look, we’ll cut that out. I’d say, I’d say, Adrienne

[00:02:18] Barrie, go, I’m back, I’m

[00:02:20] Back now. So yeah, the back story, how you grew up, why you became dentists, why don’t you start off victory?

[00:02:29] So I’m I’m the younger sister. I didn’t ever really actually want to be a dentist until I was older. I would say the Aria definitely had an influence. And we have a lot of other family who are dentists, too. But I originally, when I was like 14, 15 years old, I literally just wanted to be a businesswoman. That was literally my idea. I don’t know what that meant, but that’s what I wanted to do. And then as I was growing older, I just I realised I was very good at science. I quite like talking to people. And then I decided being the classic Iranian kind of route that dentistry might be a good option for me. Seeing our younger go through it to, I realise that actually it’s quite a nice profession and you can really do a lot with it and it’s quite flexible. And I started, Yeah, I became a dentist, and here I am now.

[00:03:19] But where did did you guys grow up in the US?

[00:03:21] So I was born in Luxembourg, and then we moved to the UK and then lived in the US for a little bit and then back to the UK again. So that’s why we’ve picked up an accent along the way.

[00:03:34] So how old were you when you left the U.S. the final time?

[00:03:37] I was, I think, like eight, eight years old.

[00:03:41] Ok, you’ve been here since then?

[00:03:43] Yeah, yeah. So it’s been ages, but I just never, I don’t know. The accent just never left,

[00:03:48] Although I think a lot of people think my accents stronger, so I think between the two of us. You don’t sound as American,

[00:03:56] Did you guys go to the American school in London? I did. Oh, that’s why. Yeah.

[00:04:01] Ok. So I was in the American system until I was 13, and I definitely didn’t lose very much of the accent.

[00:04:11] So tell me, what about your story? I mean, you enlisted dentistry before so. How did you end up going to dentistry

[00:04:19] When I was at school? I was one of those kids. I was pretty good at everything. I didn’t particularly excel the entire subject, but I was OK at everything, and there wasn’t anything that that spoke to me, particularly except for art. I was such an art kid, and because I didn’t know what I wanted to do, our mom took it upon herself to organise a lot of very varied work experience opportunities for me. And so I did dentistry and orthodontics. But then also I did reinsurance underwriting. I did corporate law. I did so many other bits of work experience and really random industries just to try and get an idea of what it is that I liked. And all of it was really boring for me at 16, except for dentistry, which was marginally less boring for me because observing. No, it’s not fun and you don’t really get a proper sense of what it is because you don’t even understand what’s going on.

[00:05:29] Do you remember which dentists you observed?

[00:05:31] Yeah, it was a more odd Milani affair. Oh, and I spent two weeks with him over a summer break and he looked at me standing there in the corner, trying to be polite and not get in the way. And he was like, You’re not going to learn anything standing over there in the corner. Get stuck in. Hold the suction. And I actually did something during the work experience, which I think a lot of people never have that opportunity to do. And so I did really enjoy it. The orthodontic work experience that I did with Siamak Bagheri, he was my orthodontist, so he did my teeth and I did experience with him and Paretta also. And from a personal perspective, the massive change that happened to my face and my own self-confidence with my own orthodontic treatment made me within dentistry, particularly interested in orthodontics. So when I finally did decide to do dentistry, I did it to do orthodontics

[00:06:38] Really like in the third year of your dental school thinking I will be an orthodontist.

[00:06:42] You knew I hadn’t started dental school yet and I thought, I will be an orthodontist.

[00:06:47] Oh, I see.

[00:06:48] And then a lot of different things throughout the training reinforced that. And one of them as as superficial and vapid as it sounds, we had our first ever orthodontic lecture in our first year just as an introductory lecture by Professor Almagro Hall. And he was so cool and I was like, I find orthodontists very cool and I want to be part of this cool group. And and then I realised when we actually got into stuck into the clinical aspect that I do really enjoy it.

[00:07:20] When you say he was cool, he wasn’t like Harley Davidson and guitar, he was. No, I get it. I get it. I’m joking. So YouTube, did you both study in the same place?

[00:07:35] Yeah. Yes. Parts of London.

[00:07:38] Oh, really? I didn’t get in there.

[00:07:41] We weren’t there at the same time, though.

[00:07:44] We just missed each other. So a lot of people mistake us or they think we’re twins or we kind of look similar. And so when I started and Brian had just left, a lot of professors would get really confused and they would like I would literally walk in like five minutes early to my lecture and they would just be shouting at me and be like, You’re late again. Like, How are you always late? I’m like, What are you talking about? This is the first time I’ve ever met you and was because lovely Ariane had left and left a really nice mark for me. But with that being said, she also did get me into the good books of some of the professors, too, so some of them loved me as well.

[00:08:20] Exactly. You got automatic friends because of me.

[00:08:23] Yeah, yeah, I bet. I mean, did you did you did you advise her to come and join, you know, to go do it at the same university and all of that? No.

[00:08:32] Oh, I. I didn’t particularly love my time at university, especially at the beginning. And in fact, I wanted to drop out of dentistry after the first term or second term. Like Christmas of my first year, I knew I wanted to drop out and quite a lot of different reasons. I didn’t like dentistry at the very beginning. It was very science heavy and I was the art kid. The science didn’t appeal to me that much. I could do it, but I was not interested in it and I didn’t love the the commute to university. I didn’t get halls and from a social aspect, it was a bit difficult and I just wasn’t enjoying it and I decided to apply for law. So during my first year of dental school, I I reapplied through UCAS to do law.

[00:09:28] Oh wow.

[00:09:28] And I got into Durham, which was the university that I wanted to go to for that. And my mom, I don’t ask me how this made any logical sense. My mom said, Sit your first year Dental school exams so that you can tell your law friends next year that you sat first year Dental school exams. I was like, Yeah, that makes sense. I’ll do that. And so luckily, I sat first year dental school exams a bit half arsed because I knew I was leaving and I passed by one point six percent and they sat me down. The professor sat me down being like, We’re really worried about your progress and Dental school because you only pass by one point six percent. I was ecstatic. I was like, You have no idea how little work I put in, and I passed by one point six percent. And at that point I was like, You know what? I’m a year end. I managed to pass without doing that much, and I might as well see it through because towards the end of that first year, it started getting better for me. And I’m so glad that I did, because I think actually law is not the profession for me.

[00:10:36] What were you like at that school, Victoria?

[00:10:38] Yeah, I was. I mean, actually, for the first three years of Dental School, I was not very involved with anything. I literally would rock up to lectures, sit in the back, leave. I wasn’t, you know, into any societies or applying for any awards or prises or anything like that. And then in my fourth year, there was an Erasmus. A Stockholm, and they were doing like applications, and you had to be active in the societies and and actually be doing quite well, and I was quite at that point. I was quite arrogant, like I would just walk in and take my exams leave. I wasn’t very into the university, if that makes sense. And then because I really wanted to go to this Erasmus and Stockholm, I started just working like a madman and I was in every society I was trying to like, you know, be friends with everyone and just really, really, I really wanted to go. And so thankfully, I got in, did my Erasmus and Stockholm and met some incredible people there who were all very like minded to me. And I think that really had a massive effect on me making friends with people from around the world who were so similar to me, but also just loved dentistry. And then in my final year of uni, I just became like the complete opposite, and I was just an absolute like. I was just working all the time, like I was applying for every single award, like I just wanted to just finish with a bang, if that makes sense. So I think I made up for it in my final year. But the first three or four years I really did nothing.

[00:12:10] I bet. I bet arriving on the Whitechapel Road from St John’s would be a bit of a bit of a culture shock. I bet it was. Was it the first time you saw that? Do you think, what the hell is that? Yeah.

[00:12:25] I love it. And I was at the old Dental School, Victoria. Did you go to the old

[00:12:28] Dental school where you were building and it just closed when I came at that point, it was just like, All right,

[00:12:35] That was beautiful.

[00:12:36] But it was. Yeah, yeah, I was quite lucky.

[00:12:40] I remember the first I didn’t go to the to the what do they call it, the where you show around the university open now? Yeah, I didn’t go to the open day. And so my first day in White Chapel was my first day of university and I came out of White Chapel Station and there was a man and it was such a comical situation. There was a man in this big raincoat and he opens his raincoat and he has gold chains and watches. I was like, I thought this was just in movies. I didn’t think I’d ever see this in real life. And that was such a significant sign of of the area at the time because actually, it’s such a cool area now. Yeah.

[00:13:24] Yeah, that’s right. So, OK, both of you, you’re qualified five years ahead of Victoria. Is that right? Yeah. So then you then went in, became what did what do you do next? What was your next move?

[00:13:38] Because I wanted to do orthodontics, I had to do go through the motions of for the application, which the first part was to do a year of Max Fox, which I did at Northwich Park and the Northwest London hospitals. And that was actually the first time that I really veered off course in terms of my ambitions to be an orthodontist. That was one of the best years of my life. And the stress of it, the terrible hours, the on call, the gore, the emotions of that year of Max Fox. I loved every second of it, every second of it. And I very seriously thought to myself, I think I might not do orthodontics. I think I’ll do Max Fox. Wow. And after that year of Max Fox, I did two months more of Max Fox in Cambridge at Addenbrooke’s. Then I got a pedes post at the Royal London, and Pete’s posts were like, I think they still are there like gold dust. They’re so hard to come by. So as soon as you hear about one, you have to go. So that’s why I left Adam Brooks only after two months started the post at the Royal London, and I still had Max Fox in the back of my head. And so I applied for medicine while I was doing pedes, and sometimes it takes just writing and sending off your application for you to really realise what it is that you want. And as soon as I put my application for medical school through the post I was, I actually I don’t want to do it, but I needed to go through that motion to know that I’ll never regret the decision of not having tried for Max.

[00:15:19] I mean, the fact you enjoyed all 30 house jobs is amazing to me. I did an oral surgery hassle and hated every second of it. I did not like it. So, you know, I guess you in that sort of in between. So do you now? Do you now think, you know, if life had turned that way, you do you regret it to some extent? Or are you fully happy that you never went that direction?

[00:15:43] I’m fairly happy. I never went in that direction. I think if I weren’t an orthodontist but I was still in dentistry, then I would have done my X-Box. But I really feel like an orthodontist, so I’m happy with it.

[00:15:57] What about you, Victoria? What was your first move out of dental school? What was the first thing you do?

[00:16:03] So I did my bit and in London, so I stuck around and then I wasn’t sure if I wanted to specialise or not, a lot of people told me I should follow my sister’s footsteps and specialise. And I was very interested in ended on text, and I just loved to get Root Canal. So that was actually where I was going to go down. And then when I finished, I was finishing up my year and I started to shadow other dentists because I wanted to see what other types of dentistry were like and what I wanted to do. So I was shadowing. I was taking a day off of work to go and shadow other dentists, private NHS specialist, general dentists, everything. And I kept on shadowing them and realise that actually, I love general dentistry and I love the fact that you can walk in and you can see anyone and you can be treating a six year old child and then treat an eighty five year old for a root canal straight after. And I found it very exciting and just kept me on my toes, and I was meeting all of these amazing people like, I mean, obviously I Ariana’s job is amazing, but for me, I wouldn’t be able to just see a certain age group or do a certain treatment. I like the fact that I can do so many different things, so I decided that I would become a general dentist, but I would kind of explore everything. And I’m one of those people who likes to kind of learn everything and then and then decide what I want to do afterwards. So I was doing a ton of courses and I went into the general dentistry. I started working part private half the week and then part NHS. And then about a year ago, I made the shift to fully private and now I. I still do general dentistry, but I have a few things that I kind of don’t want to say specialise in, but things that I focus on and that I really like doing well.

[00:17:53] I know you’ve got this role research interest in the oral microbiome, but that’s not what you’re referring to. You’re referring to it as dentists. What kind of things do you like doing?

[00:18:03] Well, actually, I do do a lot of work on the oral microbiome, but on my patients. So yeah, so I’ve started to when I was doing my research, I was realising that it’s not necessarily the quantity of plaque. That’s the issue in terms of gum disease or decay, but it’s actually the quality and what bacteria you have in your mouth. I’m sure we’ve all had patients who have what seems like a very clean mouth, and the patients got excellent oral hygiene, but somehow they’ve just got raging gum disease and you kind of blame it on like their immune system. You’re like, Oh yeah, it’s probably your body’s not reacting very well or something like that. But what I was finding was I was starting to do microbiome tests on these patients, and I would screen their mouths for the top 20 kind of pathogenic bacteria. And I was finding that a lot of these patients would have residual bacteria in their mouths from maybe bad habits 10 years ago. And if we were able to modulate that bacteria and basically kick out those bad bacteria with specific antiseptics, antibiotics like everything. So we do a lot of different things and then monitor them, we can. Then afterwards, we redo the microbiome test and see that we’ve actually kicked out that bacteria and the patient often actually not often always stabilises and their gum disease leaves and they, you know, it’s amazing. So that’s something that I it’s kind of my niche at the moment,

[00:19:25] Is that is it? Did it start with your interest in this start with you?

[00:19:30] Yeah. So and it started with so Arianna and I rewrote a paper on the link between oral hygiene and COVID 19 severity about like, I think a year and a half ago now. And it got me understanding more about the oral microbiome and kind of the invisible inside the mouth. And as you go through dental school, you’re taught a lot about how to treat Dental disease, but not necessarily how to diagnose or how to monitor treatments. And so I kind of think of the mouth now and the saliva as the like, as blood. So you go to your doctor and you get a blood test, why can’t you go to your dentist and get a saliva test and look at different inflammatory markers and bacteria and enzymes and etc.? And that’s where it all started for me, and I started working with the microbiome company straight after we published that paper and help them basically create a microbiome test, which I now use on my patients.

[00:20:26] Oh wow. So so let’s get let’s get into it. Then what? What can we what can you learn from someone’s saliva? I mean, OK, we understand there’s a link between, you know, gum disease and heart disease. There’s a link between gum disease and diabetes, right? But is there more than that? Is there a whole lot of other stuff that outside of the mouth that you can tell by testing some saliva?

[00:20:54] Yeah. So a lot of the kind of systemic like the chronic inflammatory diseases, so rheumatoid arthritis osteoarthritis. It’s those types of things, we’re seeing amazing results with our patient, so I’ve been working a lot with a couple of functional doctors near my practise and they refer their patients who they’re treating for rheumatoid arthritis, and these patients are, you know, drugged up on steroids. They can hardly walk. The disease can be very debilitating and often because it’s to do with inflammation, with collagen degradation, which is very similar to gum disease in the mouth. These patients with rheumatoid arthritis often also have gum disease, and it’s not their number one priority as unfortunately, most people, their oral hygiene is not the first thing they think of when they have other ailments. And so these patients were being referred to me, and these doctors are just like, Oh, can you just stabilise the gum disease and just make sure everything’s OK? And so we started to do that again, modulating their microbiome, checking their inflammatory markers. And what we were finding was that their rheumatoid arthritis was improving when their gum disease had been settled and there was a direct correlation between the two of them. So there’s a lot more systemic diseases where we can see that there’s a huge connexion with the mouth. I mean, Alzheimer’s is the kind of the hottest one at the moment. There’s a lot of the gastro kind of diseases, Crohn’s, all sorts of colitis, even deficiencies. So there’s so many. And I think that because of COVID and the fact that people are more understanding of their systemic health and they want to be the best kind of person they can be in as healthy as possible. It’s a great time for dentists to also show patients that there’s a strong connexion with oral health.

[00:22:41] But so, so is this field of research out there, and you’re part of it now or are you saying, you know, has anyone else said this? I mean, is it anecdotal what you’re saying or is there more more to it than that?

[00:22:56] I know there’s a lot of the there’s a lot of research which has already come out about it. I think the problem is is that dentists don’t often actually they’re not going to do anything different on their day to day like treatments for patients. So yes, we can say there’s a strong connexion with rheumatoid arthritis, but the dentist isn’t going to necessarily change their treatment plan because of that. So another problem is that I have been I mean, it’s something that I’m very passionate about. So I’ve been speaking to a lot of, you know, board of directors for these massive companies, and I’m showing them all of the the data. And this isn’t my anecdotal data. This is, you know, actual systemic, systematic reviews and our cities and everything. And I’m showing them all of these results. And a lot of these dentists are kind of like, well, the way that we’re doing things works now. So why do we need to change it? And there’s no. A lot of people are quite resistant to the change, and they need a lot of evidence before they can kind of believe it and trust it.

[00:23:54] Yeah. You’ll look you’ll find that in general, we’re trained to be sceptical. Yeah. And a lot of, let’s face it, rubbish has been marketed at us. I mean, you know, mean, you know, and also every other week, there’s a there’s a new thing that’s going to speed up orthodontics is, yeah, there’s a new bracket that’s, you know, less less friction and. And so what happened? The problem with that is that we’ve been lied to so many times our in our careers that if a breakthrough comes along, it’s much harder for that breakthrough to breakthrough. Yeah, because so many people are sceptical about it. I went through a phase of thinking, you know, maybe we can do a period product, and then I spoke to a bunch of periodontist. I just thought, no way. Because as a as a business proposition, change in the mind of periodontist is that night. Same thing with orthodontics. I sat with some orthodontist. None of them could agree with each other on anything. Yeah. And you know, we were looking at something, but it it’s very interesting. I mean, to where you can take this from the from the research perspective, you can. Are you going to bring out a product or what’s going to happen? It sounds so interesting. There should be something.

[00:25:12] There’s a few things in the pipeline. Why did you come

[00:25:14] To me with this?

[00:25:19] There’s a few I I have a lot of ideas and a few of them are kind of developing the diagnostic side of dentistry, digitalising the diagnostics as well, making what we do quantitative as opposed to qualitative. So for example, at the moment when we’re diagnosing gum disease, we’re sitting there and poking someone’s gum and seeing if it bleeds like that is our diagnosis of inflammation. And that, to me, is just nuts. Like, you know, you don’t go to a doctor and they tap on your knee and they’re like, Oh yeah, looks a bit off like they do something about it. So that’s one side that I’m working with a couple of companies at the moment, and I’m kind of advising them or I’m on their scientific advisory board, helping them develop kind of diagnostic tools to help dentists. And the idea is that if you can diagnose Dental disease better, you’ll have better communication with doctors. You’ll be able to speak to them better and say, Hey, this patient I just saw has very high levels of inflammatory markers and they have no gum disease. It may be indicative of another chronic inflammatory disease, or they have really high levels of this bacteria, and this is a bacteria which is usually found in the gut. So maybe this patient has dysbiosis. So that’s where it’s going at the moment. And then also just at the moment, I work on a lot of referrals, so most of my patients are referred by functional doctors and medicks who want to have a different type of dentist to who sees oral health is a much bigger picture.

[00:26:47] My advice to you is to get go back to Barts and get one of the big guns there and get him to front your thing a little bit, because I’ve seen I’ve seen many times great sort of innovations go nowhere because because of the wrong sort of access. But look, it sounds like you’re making waves. So really, considering it’s so new to you, it’s like since go we go, Yeah,

[00:27:15] Yeah, yeah, it’s been about

[00:27:16] A year. It’s amazing how much progress you’ve made. I mean, are you spending loads of time on this? Is it every day and every weekend?

[00:27:24] I may have a cheeky obsession with bacteria now I do a lot on. Yeah, it is. That’s why I had to take a day off of clinical work to focus more on the research side and to kind of help with these with developing some of these diagnostic tools with these companies.

[00:27:42] I mean, tell me about your story in orthodontics. You know, OK, you always wanted to be an orthodontist. Where did you train finally for your specialising?

[00:27:50] So I did the backpacks and then the pedes, and then I worked as a general dentist for a while, which really reinforced my desire to be an orthodontist because unlike Victoria, I hated general dentistry. And so it was a little bit of a drama getting into orthodontics. And it turns out that I got in, but they had ranked everybody that year incorrectly, and so they didn’t realise that I’d got it gotten in for that year. And then to try and rectify the problem, they told me that I would have a space for the year after it was just a huge drama. So essentially, when I did start orthodontics, I didn’t have a choice with where it was that I was going to end up. They were just going to give me whatever. And so I never had the opportunity to rank any of the positions, and I didn’t even know where the positions were. Having said that, I think I probably got the best position I could have ever asked for, which was at Kings for academic only. And then my clinical outposts were at Addenbrooke’s in Cambridge and Luton and Dunstable hospitals. And the reason why this particular post, it comes about once every three years, you are the only one in that post. So from a social perspective, it’s pretty isolating and it’s a ridiculous commute because every other day you’re in Cambridge or Luton or London Bridge.

[00:29:20] So from that respect, it was really difficult. But I had five six consultants looking after me and only me and I had such an intimate training. I had all the patients that I wanted. I had. I didn’t need to compete with other registrars for patients, which was the case in a lot of the teaching hospitals. So I found it extremely valuable, and each consultant who helped with my training was so vastly different from each other that I got an amazing, amazing experience. So I’m so glad that it worked out this way and that I didn’t get in the year I was meant to get in. And after the three years, so part of the three years I had to do my my dissertation for the Masters, and I did it on the impact of social media on facial and smile confidence. And it was a randomised controlled trial that we did using Instagram, and I was pretty blown away by the results, by how unhappy social media makes people about their teeth and about their smiles. And it’s kind of something that we all would guess. But we finally put figures to it, and part of the questionnaire in the study was whether or not you’ve had orthodontics and whether that affects the impact the social media has on your self-confidence.

[00:30:47] And it we found out that it doesn’t make a difference, which is a little bit disheartening for orthodontists, but I guess it shows this sort of detrimental power of social media and that got me so interested in the impact of social media on dentistry as a whole. And so I’ve done a couple of studies ever since Victoria and I have also done some studies together using Instagram using we did one on Tinder also just to evaluate the different types of effects that social media can have on teeth or vice versa teeth have on social media. So one of the Instagram studies that Victoria and I did together was to see if you’re smiling with a large Duchenne smile. So showing all your teeth, a genuine smile, whether that has an impact on social media engagement and followers. And we found that if you’re smiling a really big, broad smile, you will get less engagement really on your social media, which was kind of disheartening because we want to promote people smiling people who do smile. Really large smiles are scientifically proven to have better. You know, initial

[00:32:09] Interactions, right,

[00:32:10] But our social interactions matter dating.

[00:32:13] I don’t know. But not on social media, you’re saying.

[00:32:16] No. And I think part of that, which we discussed in the study, part of that is to do with trends. We find that things are trendy or not trendy on social media. And I think right now it’s just not fashionable to be smiling. You just it’s more fashionable to be a bit

[00:32:33] Serious, but also I think countries have as a have an impact on that too. And what like, for example, in Sweden, it’s not cool to smile as much in America, like they smile a lot more in their photographs. That also has an impact, I’m sure.

[00:32:48] No, you’re right. I went to Russia for for work once, and one of my friends had been there a lot. He sees that they don’t just smile. If you said they they they say, if you’re smiling without something funny going on, you’re a fool or something, you know? Yeah. And then and then interestingly, we had a Russian manufacturer of toothpaste manufacturer was trying to sell his stuff around Europe in the UK, and the two reps from from Russia were over smiling when there was. It was a ridiculous amount of smiling going on from them, and it’s like, obviously someone had told them, You’ve got to smile a lot when you’re in the UK, but you’re right. I mean, all the sort of cultural issues are there, aren’t they? What kind of orthodontist are you? Like traditional or do you do more of the, you know, clear aligners, or do you do it all or do you do mingle?

[00:33:41] I split my time between NHS and private, and that changes a lot. How I am as an orthodontist with the NHS. It’s your standard metal train track braces. So I do a lot of that and I really enjoy just the standard bread and butter orthodontics. I think it’s highly effective, highly predictable and it’s nice to work with. I do in the private sector, a lot of ceramic and a lot of liners, the lingual. I find

[00:34:11] It breaks your back right,

[00:34:13] Breaks your back. Yes, I find it’s a difficult sell. If I’m honest with you for me and I probably don’t sell it that well because I don’t do enough of it. So I’m not, you know, trying to sell it. But when I provide a patient with all of the options, I have never had anyone say lingual sounds good to me. They’ll either go for the ceramic or they’ll either go for Invisalign. So I don’t tend to do much lingual. I have a huge interest in many screws or Tad’s. I love them and I really want to incorporate more of that in my clinical work.

[00:34:49] That’s little implants that go in the bone. Yes. Extra anchorage. Yes.

[00:34:55] Ok. Yeah. And so when I was doing my orthodontic training, there was a prise with the British orthodontic society. It was a research fellowship. And I mean, this is the power of social media. I feel like we sound like we’re obsessed with social media. I applied for it and wanted to study the impact of social media on patient acceptance of treatment with Tad’s. And I randomly deemed a bunch of international orthodontists so too in Brazil, one in Taiwan, one in Japan and one in the U.S. And I was like, whoever answers me first will be the person that I do the study with, and I’ll put that with my application for the the research grant. And it was a guy called Daniel Figure Figaro in Belo Horizonte. And Brazil, who responded to me first and his Instagram is orthodontic world, and he’s hugely popular because of his use of tats. And so I won the fellowship, went to Brazil, did a mini school course, went to the Brazilian orthodontic conference, and then he and I did the study together to see sort of a cross cultural divide on how patients use social media to check their clinicians to get their information on treatment options and to make their decisions on treatments. And again, I thought this was even more profound than the findings I found in my my master’s research.

[00:36:29] It was 76 percent of patients want to see their clinicians work on social media, which is huge. And seventy six percent of patients get their treatment information on social media. So people in Brazil, there are slightly different rules in Brazil about how you can advertise yourself as a clinician. Then there are here. They are not allowed to advertise themselves as clinicians. They can’t pour before and after clinical photographs for the purpose of attracting patients. They can put it up for the purpose of teaching fellow clinicians. So it’s slightly different in that regard, but they use social media very, very, very well to put out good quality information so that patients understand their treatment options and understand their own treatment plan a lot better, therefore reinforcing a little bit of that trust in their clinician, the trust in their own treatment. And it ends up with providing better treatment outcomes for those patients, and I think it’s something that we in the UK are not that great with. We’re slowly getting there. There are a lot more clinicians, particularly in general dentistry, who are using social media to put out good quality information to teach fellow clinicians and to teach patients. And I think that’s so important.

[00:37:54] Yeah, I mean, we’re naturally educators, aren’t we as Dental? Yes, we’re much more naturally in an education sort of role than in a sales role. And you know, I talk about this all the time with whitening, you know, your average. Did you work today? Victoria, did you work as a dentist today? No, no. Your average dentist in a day? I don’t know. I don’t know about you guys, but I was a dentist. I used to talk to at least half my patients about dental brushing, right? I wasn’t. I wasn’t doing that. To sell into Dental brushes was I. I didn’t care about the. Sales, but I was busy doing it, I to talk to lots and lots of patients about it. You know, somehow we’re good at it. You know, it’s our role, isn’t it? One of our major roles is education and now in the social media age, it’s just another tool to educate. Right? But the funny thing about social media, I find, is, you know, I’m not very good at it, at all myself. I could see you guys are pretty good at it, but I know how important it is. I understand how important it is. So I’ve got a team of people who do ours. You know, when we have our courses and we have a section in the marketing section of the course and the guy, we’ve got different people do it. But generally people are very savvy on Instagram and all that. They say who in the room has has a social media account for dentistry, generally less than a third of the room does. And so, you know, we’re slow as dentists, we are slow to catch on to these things. By the time everyone has an Instagram account, TikTok will be the place to be. And it’s just the way it ain’t. So all right. They’d tell me this. I wanted to go back something. The sad thing, Arianne, what does it mean to me as a patient? If you’re using that, does it mean you’re more accurate quicker? What does it mean?

[00:39:47] It can mean quicker treatment times. It can mean we can make some progress with certain with certain movements without needing to put the full brace on. So, for example, if I want to disinfect a canine, I can start disinfecting it with just the tide and not have the fixed braces on, and that’ll drastically reduce the time in fixed races, for example.

[00:40:16] So literally, there’s there’s an implant stuck to the next to the canine and an elastic tuck from that to the canine and no brace.

[00:40:23] Yeah. Oh wow. Because that’s your Anchorage point. Whereas normally when we disinfect a canine, our anchorage is derived from the rest of the teeth bound together by a fixed brace. But until you get to a point where you can bind the rest of the teeth in a fixed phrase with a rigid arch wire, you’re already quite a few months into treatment

[00:40:45] And you go straight through the gum, which you raise a flap. How does it work?

[00:40:49] You can. Yeah, you can go straight through the goggles. Sometimes you might do a punch. If you’re if you’re putting a tad in the pilot, you might do like a punch incision just to if the pilot is really thick.

[00:41:00] So I want to get to this question, which is sort of this is the darker part of the conversation. What’s been what was your darkest day in dentistry? Let’s start with you, Victoria.

[00:41:18] I’m going to go dark and deep. I go to GDC complaint three months into qualifying in my year, and that was probably the darkest day of dentistry I’ve ever had.

[00:41:31] Was it about what was it about?

[00:41:33] It was.

[00:41:34] I hadn’t actually treated or touched the patient. She’d come in for a check-up. Obviously, this was fully NHS practise. The patient hadn’t come in like 10 years, and she needed a ton of fillings, root canals. She needed a few teeth taken out cetera. So I was telling her all about her treatment plan. She was like, Oh, why? Why are my teeth like this? Why do I need so much treatment? I was like, Well, you haven’t come in 10 years, but also I can see that you brush your teeth, but you’re missing certain areas, you know, trying to be nice about it. And then she was like, Why can’t I have all my fillings white? And obviously I wasn’t able to, and I said, You know, clinically, you don’t have the indications for it. I thought it went, OK. She then started shouting at me and saying that I didn’t know what I was talking about and that I was just a small young girl. Long story short, a couple of weeks later, I get GDC complaint saying that I was being racist, sexist, treating her differently based on her religion as well, and her the fact that she was wearing a hijab. So it was pretty big. I mean, I literally I’m talking like, I’m not like three months into my vti. And it was it was a horrific time. I hope no one ever has to go through that to the point where I nearly left and I was very close to leaving.

[00:42:54] And yeah, that that was that. I mean, obviously, it’s all been settled. It came out that she was actually doing the same thing with a lot of her other health care professionals and just basically suing them all on these grounds of racism and sexism. And it’s taught me a lot, and it’s definitely made me a very different type of dentist. But it’s also made me very sensitive and passionate about GDC complaints and the fact that I think that there’s this real taboo around it. And people think that if you have a GDC complain, it means that you’re a bad dentist or you, you must have done something wrong. And it took me quite a long time to realise that actually, I think that we should be taught differently at Dental School. It’s not how to avoid a GDC complaint, but more how to kind of how to deal with it. Because these days, I think that most dentists will have at least one GDC complaint and the fact that it’s become such a scary thing and and dentists are scared of telling their colleagues because they think that they’re going to be judged differently. I’d probably say this is the first time I’ve ever said it out loud, like on a podcast or anything like that that I had a GDC complaint. But there we go. Here’s the darkened and dirty.

[00:44:09] But what did you learn? I mean, what would you have done differently? Because it sounds like she was, you know, she was an outlier.

[00:44:17] Honestly, I don’t think I would have changed anything in terms of the way that I had treated her in terms of the check-up I diagnosed correctly. Maybe the way I’d said things was incorrect. I think that I’ve also over the past few years, I screened patients differently and I can kind of gauge what type of patient they are. And some patients, unfortunately, they come in wanting a professional opinion, but they don’t want to hear the professional opinion. And I used to be very like, Oh, I’m going to have to. I have to teach you all, and I still want to. But there’s different ways of doing it, and that’s something that I learnt. And I think three months in Fresh New Dentist, I thought that I was going to change the world and I was going to, you know, filling by filling. I was going to do something. And I think it’s it’s slow and you need to treat patients differently, engage them very differently.

[00:45:06] And you know what I mean, I’d expect with also you’ve got the mum who thinks you didn’t do the didn’t make the kid beautiful or something like that must happen all the time.

[00:45:21] Actually, you know, so I see an acupuncturist and he said something really funny because I’m only two years qualified as an orthodontist. And he said about how long does an orthodontic treatment last or take? And I was like, Oh, it can vary one to three years. He’s like, OK, so you won’t actually know if you’re any good at your job for quite a few years.

[00:45:45] I was like,

[00:45:45] Thanks for that. I didn’t think of it that way. But yeah, you just have to be right. So I I’ve actually bonded a lot of patients. I haven’t reached that stage in an orthodontists career where things start coming out the woodwork, which I think happens to. A lot of orthodontists, so they’re like 10 years bonded and they come out and they’re like, why did this tooth move, which is such a common complaint in orthodontics? So like, I’m not there yet. I think while Victoria was telling her story, I was trying to think of the darkest moment, and I don’t think I can pinpoint like just one. I’m just there was so many dark moments in dentistry. I tried to think twice. I felt I was like, definitely verbally, but also physically threatened by a patient’s parent. Once, when I was working as a general dentist because I was doing a root canal on a young kid. And it was one of those situations, you know, the kids really young. You could have thought about taking the tooth out and incorporating it into an orthodontic treatment plan, but then you’re going to try and be a hero and do a root canal and a crown to to avoid that. So I was doing that. And then the kid, like, stuck his tongue and I cut it with my fast handpiece when I was doing the Crown Prep. It wasn’t that bad, but there was some blood, and the mom literally tries to corner me in the room and is shouting at me and is threatening that she will personally see to it that I never work as a dentist again.

[00:47:21] And when you’re in Veatch, I mean, that’s scary at any point in one’s career. But when you’re in VTi, you’re just, you’re like, That’s it. My working life is over. And similar thing happened with a patient’s dad. When I was in my second year of orthodontic training, I was running an hour and a half late and I managed to see this kid finally during my lunch break, and the dad just got really angry. I think he was really fed up from waiting, which I understand it’s it’s never pleasant, especially to wait that long. And so he also tried to corner me, and then my consultant heard him shouting at me from his office and comes running through. And it was this weird situation because then it was my consultant, this patient’s dad, you know, standing up to each other. It was really scary to watch, but it’s one of those like autho, not orthodontics. Dentistry, I think, can put you in some really, really challenging positions and sometimes some dangerous positions because you see so many people and in so many different circumstances from so many different backgrounds. And it’s it’s a difficult, difficult industry to to navigate. But at the end of the day, we still love it despite all of this.

[00:48:37] Yeah. Well, I’ve had the the privilege of stopping dentistry and then and then going back to it. I stopped for five full years when we started enlightened and then I went back to. And when you’ve done that, you sort of get a different outlook on what it is that dentistry is, you know, and I don’t know. When I went back, I realised all the good things about it. All right. We see we meet a lot of people. Yeah, like you said that as almost like a negative because you’re right, though, you know, once you meet enough people, you’ll come across a few nutters or a few of you, few difficult people. But that that social side of it and I know, I know you don’t sort of skip into work thinking, I’m going to meet a bunch of people today, but you should. Yeah, because most, most jobs, you don’t meet a lot of people. Yeah. And then from the financial side, it’s pretty easy to make money in the industry. Let’s face it. Yeah, of course you’re going to break your back and all that and you’ve got these issues that we discussed. But but when I say easy, you don’t you don’t have to do tax right, you could keep it very simple. Yeah, it’s possible to keep it simple and earn and earn your crust, you know? And so I don’t know. It’s one of those things that it’s very fashionable to say you want to leave. And on the other hand, there’s plenty of people who love it, and it’s clear with you do. You definitely both really passionate about your work, right?

[00:50:13] Yeah. In my second year, it was around March and I cut my finger really badly with some gloss and it was my index finger and I had to get it glued and fur. I lost the sensation in my finger and I wasn’t able to bend my finger for four months or something. And at the time, because with orthodontics, you’ve got wire bending. I had my wire bending exam, I couldn’t do it. I couldn’t practise for it. So then it was an automatic fail. And then because I’d lost the sensation it was affecting, I was trying to tie modules with my finger sticking up and it was it was impossible and I was. That was a dark period for me because. Has a genuinely trying to do orthodontics with this finger. I really struggled and I was like, I won’t be able to do a career in orthodontics with a finger like this. And I spoke to all of these surgeons and doctors who said, you may not get the sensation back in your finger. And I was so upset and I was in hysterical tears. And one of the other registrars at Kings saw me crying one day in the bathroom and she was like, Why are you crying? If you can’t work clinically as an orthodontist, you can always treatment plan and diagnose and then maybe work with orthodontic therapists. And I was like, That doesn’t help me. I enjoy doing clinical orthodontics, and I really want to do it for the rest of my life. So luckily, I got the sensation of my finger and I’m able to bend it now.

[00:51:51] You know, that thing about all the therapies is beautiful, though. My son’s going through orthodontics right now, and he doesn’t see the orthodontist much because he’s a little bit. But considering we’re right at the top end in Harley Street and all of that, well, much at all, man. Not much at all. The therapist?

[00:52:11] Yeah, I don’t use them. Yeah, actually.

[00:52:14] No, not yet. Victoria, what were you going to say?

[00:52:18] Well, I was saying that we, you know, even though we’ve gone through, I mean, for me, that GDC complaint, I mean, it came with quite a lot of depression afterwards, like I wasn’t in a good place. But even so, I still continued working. And I’m grateful and I’m really happy that I did because I actually really enjoy my job. And like you were saying about meeting people. Covid made me really realise that like our jobs are very special because I was seeing all my friends and they’re working from home and they’re sitting on their laptops. And just like just doing nothing, I mean, they’re working, but like they’re just not leaving their beds all day. And I was, you know, walking to work every day, and then I was like meeting, you know, 15 new people and making new friends and I’ll come home. And I had something interesting to say. And you know, you meet some crazy people, but also you meet some. I’ve actually made friends with a lot of my patients, and also one of the beauties of social media is that you can actually continue to to speak to them. You know, it becomes a friendship. And I really enjoy that and I’ve made friends with the most ridiculous people that I would have never met in a normal environment. And now I get to speak to them and learn new things. And I think that’s really, really special. And you don’t get that with many other professions.

[00:53:33] Yeah, I mean, both of you guys look at 38 definition and you meet a bunch of interesting people that like Gaynor’s practise.

[00:53:42] Yeah, yeah, we meet. We meet some fun people, some very interesting ones. And it’s nice. I mean, so I work in two practises and the other one is it’s an art gallery meets a Dental practise. So we we meet. I treat a very different bunch of people who are a bit younger, a bit more. We see a lot of like models and actors and creative DJs and those types of things. It’s actually amazing. I have the week I get to pretend I’m cool and the other half the week I get to, you know, it’s nice.

[00:54:13] Where is that gallery one in London?

[00:54:15] Where is it? It’s in St James’s Park.

[00:54:18] Oh, nice place. Yeah, I think to see that, I’ve heard a lot about it, I have to go there one day and actually see it. I’ll come and I’ll come and have lunch or something.

[00:54:27] Yeah, come round. Yeah, it’s an

[00:54:28] Amazing kind of art, is it? Yeah, they have so much Dental memorabilia.

[00:54:34] Yeah, yeah. I think we have the most Dental memorabilia in the world or something like the oldest Victorian like Dental. I know forceps or something.

[00:54:43] Who’s the principal

[00:54:44] There? His name is Jerome Siba. He’s a he French dentist.

[00:54:49] Amazing. Yeah. So listen, we talked about dark days. Yeah, I want to talk about regrets. What’s what’s your biggest regret in dentistry?

[00:55:01] Oh, it’s a really tricky question. Do you remember The Queen’s Gambit when it came out and she sits there lying in bed and she looks in the ceiling and she sees the chessboard? And yeah, I feel like I do that all the time with orthodontics, and I’ll lie there in bed feeling like if I put in the last americ chain over here, it’ll drag the canine out this way and then the anchorage, blah blah blah. And I, it sounds ridiculous, but I feel that. And then some so often some of my regrets are like, Oh, I should have put on a No. One, six nine and I don’t know, one four. And I tie in that case. She’s a real

[00:55:38] Party to be around sometimes.

[00:55:43] And so I get that a lot. But in terms of like a big regret, I’m just trying to think. In terms of my career pathway, I

[00:55:53] It’s kind of it’s kind of what would you have done differently if you could like, if you could rewind? What have you done differently?

[00:56:00] I’m not sure I would have. Oh, OK. No, I do. Ok, so when I didn’t get into orthodontics that first year that I applied and then it turns out that they were wrong about not getting me in. So that year I worked as a general dentist and I worked in three practises at separate times. So I did a stint in one and then a stint in another because I was so unhappy at all of them. And part of the reason with that was because it was my first time really working as a general dentist. And you don’t value yourself that much as a clinician when you’re starting out and when somebody offers you a job. Or at least this was the case for me. When somebody offered me a job, I thought, amazing. They offered me a job. I have to take it. And so I was not discerning about the job offers that I was receiving at that time. So that was my biggest regret was, I think, undervaluing myself as a clinician. I’m not saying I was an amazing general dentist or anything, but to find a job that worked for me with a team that I would enjoy working with in an area that I wanted to go to. I just thought I got a job. I got to take it.

[00:57:13] Yeah, I see it quite a lot. A lot of people ask me for advice. Younger dentists ask me for advice. And I hear people say stuff like, I’m I’m 10 years out of dental school and I’m not sure if I’m ready for private yet. And I’ve been by, so I did vote and said, I want to go private. That was that was just, you know, I didn’t even think about, am I ready for it or aren’t you ready for it? I was a bit the other way around. I was I don’t know that I could manage the NHS. And isn’t that what you’re saying about? You could call it valuing yourself or whatever. But those decisions that you make that you have to sometimes sit with people who say, you know, you can do private land. There’s no there’s nothing. There’s not a magic to it. The main magic to it is empathy or, yeah, not hurting people or whatever. So what would you say? What would you say, Ariane as an orthodontist? One of the main skills outside of those patient management skills, like you sounds like you are looking at things in a sort of a 3D way, whereas I wouldn’t I kind of see teeth. And so, you know, a lot of general dentists are taking on Dental taking on orthodontics. Tell us, tell me a couple of things that you know, they’re not they’re not aware of or they they should be aware of or mistakes that you see people do.

[00:58:38] I think one of the most important things about sort of dealing with orthodontics as an orthodontist or as a general dentist is being very creative. That’s what I love about orthodontics is that you can be so creative when you come across a problem. There are so many different solutions for that problem, so you have to keep a very open mind. There are so many materials that you can use, so many different appliances that you can use, you can mix and match. I mix and match so much. And since qualifying as an orthodontist, I do it so much more. And you know, you might put a segmental fixed race in one half and then something else in the other half. You’ll use different appliances over different courses, different parts of that same treatment and things like that. And that’s what I find some people lack, especially people who don’t have that much experience. And for example, with Invisalign, I heard that there are a lot of people who get a clean check and they think, OK, clinic told me to do this. So I need to do this and I need to accept it. And that’s problematic, because why are why is the eye better than you? It’s not. You need to challenge and question the treatment plan that’s suggested to you and think about the other options. There are so many other options outside of that. So it’s that creativity and keeping an open mind that there’s always something out there and it might be something that you don’t offer. You’re not good at. There’s plenty of that. I, as an orthodontist, refer to other orthodontists all the time because I think, no, actually you need to see this guy because he’s better at that.

[01:00:19] What about what about those of the composite bonding piece at the end of Ortho? Do you take that on yourself or do you pass that on or

[01:00:26] I don’t do it. I will pass it on. Victoria sometimes does it or a patient who has their own general dentist, they’ll do it. And this is kind of an issue, actually, because especially if patients are seeing before and afters on Instagram, and then you see this beautiful case with alignment, bleaching and composite right done, say, by a general dentist, and the finish looks stunning. My finish won’t look as good because I’m not doing the composite and the bleaching afterwards, so I’ll finish to a beautiful orthodontic result, maybe. But the shape of the teeth and the colour of the teeth isn’t that great. And that’s something that I think is a slight issue in terms of patients because they’ll be like, Oh, like that, other dentist is so much better. But actually, no, we’re both good. They’ve just done a little bit more at the end of it.

[01:01:18] But I mean, in your training that the idea of aligning each born, you know, was that was that discussed at all or never? Because in many ways you could get the gingival part right as the orthodontist and leave the incisal to the restorative guy, you know?

[01:01:35] Yeah, which which we do. So we did train a lot with working with restorative colleagues. When I was at Addenbrooke’s, we had an amazing restorative consultant who did that stuff, particularly for hypochondria patients. So that is part of the training and it is very valuable. But when you’re working, say you’re working at an NHS orthodontic clinic, you have so many referring general dentists. And I don’t know some of them that well, and I don’t know whether they’re happy doing the composite.

[01:02:08] I guess I guess I’m talking about more adults also, aren’t you? Because, you know, by the time able to just relax. But but by the time you’ve worn these teeth down, you’re an adult like most kids haven’t yet worn them down. So that might be why you’re not coming across it as much in kids. But but how much of your work is? How much is that? So it’s all your NHS kids and all your private adults, it kind of bands

[01:02:32] Up all my NHS kids, then my private is probably. Forty per forty to thirty five percent kids. Oh, really? And the rest adults, yeah.

[01:02:44] And a kid’s asking for Invisalign now.

[01:02:46] Yes, surprisingly because I think for a kid, it’s it’s OK to have braces. Everybody has braces, but I’m getting so many more saying, no, it has to be ceramic or no, it has to be Invisalign.

[01:02:59] And it has Invisalign improved, in your opinion, to the point, I remember 10 years ago when I was doing Invisalign, every orthodontist would say it’s not as good. You can’t move the teeth in the direction you want to, whereas now I’ve come across a couple of orthodontist who only use Invisalign. So was it improved, is it is it?

[01:03:22] I definitely think it’s improved, I think it is excellent and the eye is very strong and it’ll only get stronger. Those treatment plans in the clinics that are coming through will only get better the more and more we use it. But I don’t think it’ll replace fixed appliances. There are certain situations where you have to have the fixed appliances. I just I can’t see a situation where an airliner can do as good a job as a fixed appliance in certain clinical cases in the majority of cases. Yeah, I think it’s a viable alternative option. But if you’re disinfecting a canine, I should think it would be so difficult for you to do with an airliner. It’s not impossible, but you’ll just be wearing Invisalign the whole time. I just finished my Invisalign done by Victoria. Victoria’s just started her Invisalign that I’ve put for her. And now that we’re seeing it as a patient,

[01:04:16] It’s a tough dream that,

[01:04:17] Yeah, yeah, the compliance is so difficult and we finally understand it from a personal perspective. Victoria was making fun of me being like, You’re the worst patient ever, you’re not compliant. And I was like, No, I’m every patient. I’m just being honest with you about it.

[01:04:32] Yeah, it’s a tough, tough, tough treatment. But you know, we were talking about we talk to our dentists about whitening after Invisalign. And, you know, a lot of people sell this sort of free whitening within this A-line thing. And obviously in life, it’s never going to be free. And so the time to have that conversations at the end of it, Invisalign online, not the beginning, because at the end, they’ve just been through the hassle that is Invisalign. And once you’ve been through that hassle, sure, you’ll finish it off properly. But at the beginning, you know you don’t know what you’re getting yourself into, right? Yeah. Victoria, what’s your what’s your dream come true with regards to the whole microbiome stuff? I mean, if I was a Russian billionaire and I was like willing to fund you to the hilt, what would you say? What would you say would happen? Go hit me

[01:05:25] For everyone to have symbiosis and everyone’s bacteria to all be balanced and equal?

[01:05:33] Well, obese. Yeah, exactly.

[01:05:36] I want world bacterial peace. That would be the dream. I mean, real talk, I would say from a dentist perspective for more dentists to understand the oral microbiome. I mean, when I was at university, I we had maybe like, you know, a few lectures on the microbiome and I just memorised some bacteria and then I just spat it out on my exam. And that was the end. And I never thought I was going to have to know about this bacteria ever again. So the dream would be for dentists to actually like, appreciate, understand what the microbiome is, what bacteria is, how important saliva is, and then to use it to their advantage by checking the saliva for certain things and trying to modulate the microbiome. And then from my side, it would be to hopefully create like a protocol. So I am thinking of maybe teaching other dentists about the microbiome more and how to modulate it. There needs to be a lot more research that goes behind it first, but it’s it’s in the in the working at the moment.

[01:06:37] It’s a fascinating subject. I’m sure people will want to learn about it. Yeah, the thing that seems to drive these things is a kind of a use case, a sort of a how am I going to make money out of this kind?

[01:06:49] Well, that’s the problem. I had a discussion with someone actually recently who not a very nice person, actually, but they I was talking, he was a dentist and we were talking about what we like to do, and he was just like to slap on veneers. And, you know, like, that’s my my thing, and I’m making loads of money at the moment. What do you like to do? I was like, Oh, I like to modulate microbiomes. And he was like, Where’s the money at that? And that is a problem. I mean, it is expensive for me in the sense that we have to do microbiome testing and we have to do this.

[01:07:25] Definitely money there is, but it’s there’s no doubt about

[01:07:29] That we need to work on. I mean, at the end of the day, it’s never going to be the same as doing a smile makeover. And that’s the problem and also with the microbiome because it’s non shedding and because it’s essentially quite stagnant. Once you get the bad bacteria out, that patient could be actually good for the rest of their lives. They might just need some modulating treatment for like six months and then they’re good. So it’s it’s great for patients, though, so the

[01:07:52] Dental model needs to change a little bit. But you know why? Why do we only get paid when we cut? Yeah, it’s it’s it’s one of the things I guess, you know, in shorts and then bland capitation was trying to look at that. But you know, I see that if every dentist in every exam did a microbiome test. Yeah, it’s a gigantic market, right? It’s much more of a market than than.

[01:08:18] Hear cases and they’re loyal, the patients who see me at the moment, who I’ve been working on their microbiomes and getting them back to a place of health are the most loyal patients I’ve ever seen.

[01:08:31] I think you’ve got to stick at it because the gut microbiome is so, so, so fashionable. Yeah, yeah. Everyone’s talking like it’s become a thing everyone’s interested in. Yeah. And at the end of day, this is just this is the beginning of the gut, right? Exactly. That’s the way it used to be. Yeah. Guys, it’s been a pleasure having you. We normally end with this sort of end of life type of questions, how know legacy type of questions? Let’s listen. Let’s go there. Let’s go there. You’re on your deathbed. Great. You’ve got your nearest and dearest around you. What a three pieces of advice you would give them.

[01:09:13] Arianna, you can go first.

[01:09:15] Oh, dear. Ok, three pieces of advice, I’ve never thought about this. Don’t worry too much. And Max Fox taught me that. Stay humble. And smile,

[01:09:35] Enjoy, enjoy, right? Yeah, I. Go ahead to.

[01:09:41] I’m. Can I give you my mantra, like how I, how I live my life, if that makes sense? It’s not like three things. So when I was younger, I had this idea that our life is only truly happy when we it’s called the four corners of Life. So you’ve got friendship on one corner, family on the other corner, and then you’ve got your academics when you’re a child and then that will transcend into work or business or whatever. And then relationships on the other side, which eventually might become your husband, wife, etc. And then the centre of it all is your health and in life. We always want all of those to be perfect and they never are. And what we all have to remember is that, for example, you’re really stressed out with your exams or you’ve you failed an exam and you’re really upset about it. You need to think back and be like, OK, well, fine. My academics aren’t doing so well right now, but I have a family I love. I have friends that are great and my health is good and to kind of always be grateful for the other things in your life. And whilst we’re always trying to achieve this perfect four corners or et cetera it, you need to also be happy with where you are at that moment in time.

[01:10:56] Did you come up with this yourself when you were a kid? Yeah, it was

[01:10:59] The little baby philosopher. I had this.

[01:11:01] She was very

[01:11:02] Wise. Yeah. It came off and then I used to draw a little square on my wrist when I was upset about like, if like, for example, I had a really big falling out with a friend or, you know, I was upset at someone or something like that. I would draw my little square on my wrist and before every exam as well, and it would remind me that my life is still good and there’s so much worse that could be happening right now that just be grateful for what you have.

[01:11:29] That’s lovely, man. The next question, the next question. People worry about, but don’t worry about it just to I don’t know why people worry about such an easy question. Just just say whatever comes in your head and it’s Victoria first, this time dinner party. Three three guests dead or alive. Is it going to be, oh, to say one? And then I will say the next one. Oh. This is a classic classic perfectionist types who can’t can’t say an answer, this is the perfect answer.

[01:12:03] Can I guess what a guitar is, Gus? Well, yeah, I think Victoria wants somebody from Russian politics to Putin. Yeah, probably Putin. I’m going to go back.

[01:12:16] I want Stalin.

[01:12:18] Stalin, OK.

[01:12:19] I want this weird fascination with Russian history and communism. When I was like 18 and I was obsessed, like, not in a weird way, but I just found the the head of Stalin and everything that he did just insane. So I would love to, you know, have a chat with him, understand what he did.

[01:12:37] I look, can we do that era, you know?

[01:12:41] Yeah, yeah.

[01:12:41] It’s just it’s just can I guess Victoria’s three and then you guessed mine. That’s interesting.

[01:12:45] That’s OK. Let’s do it.

[01:12:47] Ok, so Victoria wants Stalin. I think like a really big businessman. So like Gordon Selfridge or something, somebody like that could do that. And then the third one would be Henrietta Lacks.

[01:13:02] Oh, I would love Henrietta Lacks.

[01:13:04] Who’s that?

[01:13:05] That is so Henrietta Lacks, is she? Her cells were the first immortal cells to ever be found, and this was, I don’t remember the year, but they’re basically HeLa cells, and that was what penicillin was made on. And it was the she basically had cancer. They found some cells, which were just constantly keep on dividing and replicating, and they took them from her and they spread around the world. And now they’re used constantly. But at the time, because she was African-American, they didn’t treat her correctly and they just stole her cells and she died. And then, like, 50, 60 years later, her family realised that, like so much of modern day medicine, was created based on their mother’s cells. And it was this huge legal issue of like, do they have any rights to these cells and and do African-Americans have rights and medical rights? And yeah, so we’d love to meet Henrietta Lacks as well. But I don’t think Gordon Selfridge, I’m going to go for like a like Solomon, like I want to, you know, let’s make it. I want to have like a little bit of a party whilst we’re having dinner.

[01:14:14] And that’s a good guess. Go ahead, Ariane. What are we going to? Victoria’s going to get to give us some clues about Ariane?

[01:14:19] Oh, I’m going to be the worst of this. Ok, she’s going to want like an artist of some sort.

[01:14:25] What’s your favourite kind of author?

[01:14:27] Post-war, contemporary? I’m particularly figurative, so I’m going to answer. You’re right about the artist. So one of the artists that I would, the woman with the wax. Now, never mind. Yeah, yeah. No, I don’t want her, I would want Pietro Mazzoni, who is an Italian artist. He was part of the Italian movement called Arte Povera, where they couldn’t afford artistic materials, so they would make art based on what they could find. And so he made a lot of art with bread rolls and cotton wool and just really random things, and

[01:15:04] He became his art. Hmm. Yeah, it’s very interesting. It’s very interesting.

[01:15:10] It is. I mean, he he was famous in his lifetime, and as a famous artist, he thought, I’m an artist. I so whatever I touch and produce is art. So he started putting his thumbprint on eggs. And then he also filled a tin with his own excrement, sealed it and sold it for its weight in gold.

[01:15:31] Yeah, and I was looking at that right now. Yeah, it’s artist shit. Yeah. Is it was. It was very good. Yeah.

[01:15:42] And I love that. And it says somewhere that if you open the tin, it will no longer be worth its weight in gold. And so nobody dares open the tin.

[01:15:53] Ok. Piero Manzoni, who else?

[01:15:56] Who else would are good?

[01:16:00] So would you want a musician? Meet who a musician. You know, that means take it. No politician, no, I don’t think you’d want a politician. I don’t know. Give me a guess,

[01:16:14] And if you know yourself.

[01:16:16] Obviously, I don’t really know. I’m trying to think only bigger. Maybe Timothée Chalamet, who? Google, that Google him, the actor.

[01:16:27] He’s very good looking because he’s good looking.

[01:16:30] Yeah, basically

[01:16:33] Who I know, either someone from Schitt’s Creek or from Family Guy or from one of those TV shows that you love.

[01:16:44] You’re making me sound very superficial, I’m not I think it be, I’m making myself sound very superficial.

[01:16:50] I sound like a psychopath. I want Stalin and Solomon in the same room at the same time.

[01:16:54] I’m not any better than you. That’s one hell of a party you got. Yeah, go and hit us. It doesn’t, you know, it’s not about how you sound. It’s about who are the three people? Yeah.

[01:17:07] Oh. God, I can’t possibly think, Candy.

[01:17:17] I’m getting a lot of Gandhis, so, you know, I love candy.

[01:17:22] I feel like that’s like the PC. Yeah, exactly.

[01:17:24] Yeah, no. Like one of the guys at my dinner party, I don’t even know his name. Yeah, it’s the guy behind Red Bull. That guy. Why? Oh, I just love. I just love what he’s done. I just love war. I want to stick with that guy and say, Well, that

[01:17:40] Was that jeweller

[01:17:41] That you really like in.

[01:17:44] Nadine Goss. Yes. Her in there. Nadine Goss is one of my favourite jewellers.

[01:17:51] Okay, so you win the prise, but I didn’t know any of your three guests the first time that’s happened. We’ve only got to now. Yeah, because because Stalin and Solomon might do well, those three, I’ve just I’ve just learnt something.

[01:18:10] I feel like you don’t want to come to my my dinner party and you’re invited.

[01:18:17] Guys, it’s been a real pleasure to have you. And I know, I know in these things when there’s when there’s two people on, it sort of feels like we only just touch the surface. But with you two, you kind of know each other so well, it’s interesting you. Three questions for each other to connect with you guys. As I said, the Dental sisters and your papers and things. Where can people pick up your papers?

[01:18:42] It’s on orchid, right?

[01:18:43] Would you submit?

[01:18:45] Payman just sticking to its collar, yeah,

[01:18:48] Yeah, yeah, yeah, should be up there.

[01:18:51] Yeah, well, it’s been really lovely to have you guys. Thank you so much for taking the time to do this

[01:18:55] And thank you for helping us. This was really fun to see both.

[01:18:59] Thank you.

[01:19:00] Thank you. Bye. This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry.

[01:19:14] Your hosts Payman Langroudi and Prav Solanki. 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.