Alan Burgin is perhaps best known by his Instagram alter-ego, The Cornish Dentist, whose informative how-tos have earned Alan an impressive follower count among fellow professionals.

He sits down with Cardiff University alumni Payman to explain his journey to being one of the UK’s most promising young dentists and talks about life in Cornwall and early years in max-fax.

Payman also puts Alan on the spot about rubber-dam placement, suturing and composites.

Enjoy!

 

“The majority of my career and progression has basically been a series of high-pressure situations that are sink or swim, and so far I’ve been swimming. But some of them – I think – were close to the mark.” – Alan Burgin

In This Episode

01.41 – Backstory

07.04 – Confidence

10.15 – Cardiff and dental school

14.09 – Max-fax and oral surgery

21.54 – Travel

27.43 – First job

29.28 – Implants

37.39 – Social media

44.40 – Cornwall

46.48 – Phobia and sedation dentistry

48.30 – Full-mouth dentistry and stabilisation

55.11 – Finding and teaching your niche

01.02.17 – Rapidfire top tips

01.06.39 – Blackbox thinking

01.17.18 – Future plans

01.19.20 – Last days and legacy

 

About Alan Burgin

Alan graduated with honours from Cardiff University in 2012 and took on a post as a senior maxillofacial house officer at Newport Gwent hospital.

He practised in Wales and bath before settling in Cornwall, where he practices at Pure dental, focusing on full-mouth rehabilitation.

Alan has amassed 10K+ followers as Instagram’s The Cornish Dentist,

[00:00:00] Phobic patients who basically just need time. So many of them, so I’ve done sedation training in the last few years, but so many of my sedation patients, we sedate them initially and I try and wean them off it. That’s kind of my goal, and that is life changing treatment. I have a guy who he wouldn’t let us take photos even in the waiting room. He cried, coming up the stairs the first time he ever came in and he wouldn’t sit in a chair. It was traumatic just for him to come in the practise.

[00:00:29] We did

[00:00:30] A fair amount treatment under sedation, and then a couple of months ago, we placed two lower implants

[00:00:34] With no station and

[00:00:36] Us and

[00:00:37] Fulfilling. Isn’t it

[00:00:38] So good? So, so good?

[00:00:45] 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

[00:01:02] Gives me great pleasure to welcome Alan Bergin onto the podcast, a.k.a. the The Cornish dentist. Nice to have you, buddy.

[00:01:11] Hey, Payman. Yeah, thanks for having me.

[00:01:14] It’s a pleasure to have you, buddy. I’ve come across your work mainly on Instagram, and I’ve got to hand it to you that that’s a great page. You’ve got going on the dot dot doesn’t matter. The Cornish Dental is what I love about it is that, you know, you kind of almost breaking the rules of Instagram in a way. It’s not quantity, it’s quality. Whereas, you know, a lot of people think I have to post every day and you’re not you’re not posting

[00:01:39] Anywhere near that that amount.

[00:01:41] But every time you post, it’s it’s a pleasure to go through what you’ve got there. And for me, I tend to break down dentists. I mean, it’s a dentist page, really, isn’t it? It’s not. It’s not a patient page, but I tend to break down dentistry. It’s almost like breadth or depth. And you it’s almost you’ve got both going on, which is really difficult to pull off so many different aspects of dentistry going hot on that page. But let’s let’s let’s get to the to the sort of the origin story. Where did you grow up? Why dentistry? What kind of?

[00:02:18] So yeah, I grew up in the south east in Surrey and pretty normal, normal upbringing. I went to a school in Reigate, played quite a lot of rugby. My dad was an engineer. He sort of worked his way up. He came out of out of school with pretty minimal qualifications and through hard graft and whatever worked his way up to doing well in engineering. And my mom actually was a dental therapist and talk therapy even in London, probably like thirty five plus years ago.

[00:02:54] Oh, and which is interesting

[00:02:56] Because, you know, my wife’s a therapist and, you know, they have the same discussions that they were having 35 years ago about their involvement and all that sort of thing. But you know, it wasn’t that classic of, you know, mums in the industry and you move, move, follow in their footsteps. I really wasn’t that aware of what she was doing and actually she wasn’t in dentistry when she had me. My sister’s three years older and she sort of finished finished that between the two of us. And then she had worked in a nursery in the nursery school for 20 odd years. So, yeah, I grew up in in and around Raleigh, in Reigate, and then went to university in Cardiff. Let me stay with you. Yeah, yeah.

[00:03:42] What made you do dentistry? How did it? Was it your mum was? It was that it really wasn’t.

[00:03:46] And actually, I didn’t didn’t even really start chatting dentistry until I was doing it with with her. And I think that was that’s kind of my sort of parents style of upbringing, I think the whole way through. They’ve always been there to sort of guide and help. But at the same time, in no way said, do this do that, they’re really been there are great in that way. And actually, it was I had a great dentist that I went to religiously every six months and there was never anything wrong. And you know, I can imagine my mum was pretty on top of our teeth and everything. So then I went to her braces and I kind of all of a sudden I was like, Oh, this is this is different. This is this is still teeth. And actually, to be fair, I walked up the orthodontist practise and I think there was like a BMW and Mercedes couple, the nice cars at the front. Oh, this is interesting. And then so I actually did some work experience in engineering because I was doing the sciences and whatever. My dad was like, Oh, maybe you know, you might like engineering and it wasn’t for me. So next door to our school was a really top private Dental practise just by a complete fluke. And I just I just went in there one day and said, You know, I’m kind of interested and I might be doing dentistry, just wondering if I could come and shadow you at this lady in there for a bit.

[00:05:22] And lady called Jill Nightingale just an incredible dentist, actually just the loveliest lady. And she said, Yeah, sure. So I went and saw her, I think, for like a day or whatever. And back then it was all about you, as it is now, I’m sure. But the UCAS application and trying to show your interest and something a bit different. And I had I think it’s like a double or triple free period every Friday. And I just I said to Joe, You know, can I? I’m literally next door. Can I come in for, I don’t know, a couple of months, just every Friday morning and watch you? She is. She’s totally on board with it. Yeah, yeah, absolutely. So I just went and observed her. Asked her loads of questions, probably got in the way of it, but she, you know. One thing actually, she said to me that I always remembered was, she said, you know, I reckon about 50 percent of dentists hate their job and about 50 percent love it. It doesn’t matter what you do, just make sure you’re in the right 50 percent and that that kind of stuck with me all the way through, really. So that that sort of sparked my interest here.

[00:06:33] I remember Alan Gilmore in Cardiff saying something like that as well. Yeah. And yeah, yeah. So, so true, isn’t it? Because, you know, if you could bottle your enthusiasm for teeth and you know, I’m sure, you know, we’ll get onto that. You can bottle that. You can you can teach, you can, you can talk about it. But I guess it’s something to do with continuous improvement, though.

[00:06:59] Yeah. Yeah, I think absolutely, absolutely.

[00:07:04] And that’s what we all want to get back. I want to get back to your childhood quickly. It’s a pleasure. If you don’t mind. But you know, I listen to your podcast with jazz, and I think everyone should, because I’d rather not just covered the same, the same thing I’m glad to get. But what came through that podcast for me was your just confidence as a person, not not talking about dentistry, but as a person, total confidence. And have you got a kid?

[00:07:31] Yeah, yeah. 16 month old little boy.

[00:07:34] Ok. Early, early. But I’ve got I’ve got kids. And you know, in the end,

[00:07:39] What better thing can you do

[00:07:40] For your kids than give them confidence?

[00:07:43] So do you remember

[00:07:44] Being not confident ever? And then a moment of inflexion? Or were you just always naturally that that kid?

[00:07:52] You know, I don’t think I was that kid. I mean, in some circumstances, yeah, for sure. But my my dad, he’s one of his big hobbies. When he, when we were younger, was acting and he was at this local theatre group, that was great. And my sister went there every weekend and did this little workshop and quite a few of our little friends did. So I went along with them because they were doing it, and I just never really clicked for me. I just didn’t have that get on stage and be the confident guy. I don’t know if it’s confidence or just didn’t click with these people. I don’t know. But I didn’t gel into that into that group, so I definitely didn’t feel that. Yeah, confidence at that stage. But then, you know,

[00:08:43] Do you remember, when do you remember when you did? I mean, you’re definitely a very confident person, a doubt about that, right?

[00:08:50] You know, reflecting on that podcast with jazz was when we chatted all the way through. I sat back afterwards from that and thought, Do you know what? Actually, the majority of my kind of career and progression has basically been a series of high pressure situations that are sink or swim. And so far I’ve been swimming. But some of them, I think, were close to the mark

[00:09:15] Of,

[00:09:17] You know, actually actually getting through it. And I remember times in I did a maxillofacial year. I remember walking over to the ward once going down to A&E and I did it in Newport, which was

[00:09:31] There was, I think I’ve been to the hospital. Yeah, the hospital was a plenty of

[00:09:37] Plenty of trauma to work on there. Amazing place to work for a year, for sure. But I remember striding down the hallway with my staff grade and she said this is the vertical part of the learning slope. And so I would say, I say it probably initially stemmed from team team sport, you know, being in with the rugby guys. And yeah, as always, not the loudest guy, but I was having a joke and a laugh. And yeah, I definitely felt confident in those scenarios, for sure.

[00:10:15] When you when you pick Cardiff, did you pick Cardiff because you knew about the rugby?

[00:10:19] No, no, no, no. So I don’t know. So there’s that situation. I think it was like four or five universities and I put down Leeds, Cardiff, Sheffield somewhere else. And then my last one, I was saying to my mom was like, Oh my go. I like Manchester or Newcastle. And she went, You know, like my parents guided me, but they weren’t in any way push you on anything which was like, Why don’t you? Why don’t you think about

[00:10:53] Kings, which is like,

[00:10:55] You know, forty five minutes away? I was like, What? What she’s like? You basically picked the four universities at the furthest away from Surrey. Why you think about kings? I thought, Why don’t we go kings is like,

[00:11:07] Well, you know, they

[00:11:08] They look a bit more on personal statement. I think I was like, I don’t think I’m going to get the grades they’re. Thanks.

[00:11:13] Thanks for the service.

[00:11:17] And so I did put things down, I did put it, but yeah, I got I got, you know what it was actually. In all honesty, I went to the open day at Cardiff and I went and had the interview and I just really in the interview waiting room and all the other places. It was kind of like, no one’s talking to each other, just sitting with your parent you’re with and focus on the interview. Cardiff it was like all the young people sitting around a big table, just having a chat and getting on with each other. And I thought, Yeah, this is this is my mix of people, to be honest.

[00:11:55] It’s such a great city. I mean, the Welsh themselves and Nakumatt. I mean, I’ve travelled up and down the country and there are good people in a lot of different places to tell you the truth. I mean, there are different types of characters right in. In Liverpool, you get loads of funny Scousers. Everyone’s a comedian and everyone’s got some sort of side hustle going on. But in Cardiff, the warmth of that

[00:12:18] Community of of Welsh

[00:12:20] People and and you worked in Rhondda as well, right? Yeah, the whole other oh even more a deeper sort of family sort of situation. I just love the Welsh band. It’s stuck with me since, you know, I left long before you did, but just wonderful people.

[00:12:39] It’s one of those ones, though, that I’ve got so many great friends still that well, of course, they all still live there because none of them leave, in fact. So we went on, we went on a sports day once to Leeds. We at one of the boys, I think he was in the fifth year. He was getting a little panicky as we’re getting towards the bridge. Let’s see what’s up.

[00:13:03] He’s like. I got my passport.

[00:13:08] He never left way of getting to touch about it, but yeah, so. Brilliant, brilliant group of how

[00:13:16] Do you find Dental school?

[00:13:18] I loved it. You know, I wouldn’t say it was certainly wasn’t top of the class. It wasn’t bottom. I was just in the middle doing OK, trying to find a balance social, I guess with with education, and made it to most of the lectures, pretty much pretty much all lectures. But I think I definitely I definitely enjoyed it more when we got to the sort of hands on endowment, that was more me.

[00:13:47] Yeah.

[00:13:48] How did you meet your now wife there as well?

[00:13:51] Yeah, yeah, yeah, so she was I was in second year and she was first year. We had a couple of joint lectures together. And it’s yeah, she’s from Cornwall originally. So. So we how we ended up here.

[00:14:07] So then tell me what you did after you qualified.

[00:14:09] So when I qualified, the first job I had was in max facts, and that was through a situation of mishaps in applying for Viti and just went horribly wrong. Just a nightmare. Basically had no other option. Literally one job, probably probably in the country, because I couldn’t. I didn’t have a NHS number, so I couldn’t do any of the DfT posts that had community with them, which was pretty much all of them. But there was one one matt fact post where basically the consultant there, great guy. John Llewellyn, small but fearsome consultant. I think the past, however many years, he was on a Tier two scheme and he’d effectively every dentist that did the first six months. He would pinch them for the second six months, and they kept losing out on this beauty spot. So they in the end just gave up and made it at 12 months max back post, but kept it as deaf, too. So. So that was pretty much the only job I could apply for. And just by complete fluke, I had a two week placement there about a month before the applications for that place and and my my very good friend who was partnered with she, she basically went up to him and said, This guy’s not got a job. You know, she’s she’s born and bred Welsh and the confidence in her. She just just had my back and said, This guy’s not got a job. He’s going, he’s applying for this place and then sort of looked at me like,

[00:15:50] Oh, right, okay, let’s

[00:15:52] Let’s test him out. See how it goes. And I had a few sort of string of successful things in that post, just like us taking out our wisdom teeth and that sort of thing. And then I applied for it and got it, which he never let me forget for the whole year, really, that he gave me that opportunity.

[00:16:12] And did you enjoy Max? I did the max factor job too in Cardiff and I I I hated every moment of it and really did. It just wasn’t for me. Did you enjoy it?

[00:16:22] I loved it. I did love

[00:16:24] It. I think there’s a few things that go with that. One was the the home team. We had a great group of people all really like in it together, you know, and there was none of this lazing around, handing over piles of patients. I lived with two of them who were two years above me in uni, so that was a great shoulder to cry on at the end of a long, long shift. But the other was it four or five of them, just just a really tight group of house. But we kind of had to be because I think we had like three. But no registrars for consultants, I think three staff grades. Well, one of the staff grades went off on maternity. Then we’re down to two. One of them went and did medicine. And then I think later on the other one did. And at one point for about a month, we had seven hos and four consultants, and that was it. And so it was a combination of, you know, the consultants getting pissed off when we called them about something very basic combined with what I really want to call them about this. So probably one of those first single swims,

[00:17:36] I think I’d recommend anyone to do it. Because it puts you in these situations that puts you under so much stress that then nothing else seems to stress to you after that.

[00:17:49] But yeah, for sure.

[00:17:50] For sure.

[00:17:51] Unfortunately for me, the first few patients we had passed

[00:17:55] Away, you know, after the

[00:17:56] Operation and I’d come straight in that situation, and the consultant was understandably stressed by the whole thing. And yeah, I found it really hard, man. I found it really, really difficult. But I still think it made a man in me. I do. I do think that, you know, I remember fracturing a few porosity back and my nurse just going berserk and eating like it was like no, nowhere near as bad as the things I’ve seen.

[00:18:27] Yeah, yeah. Yeah, yeah, I think I think it’s so true. Yeah, it does make a man. I mean, I remember a couple of just horrific traumas

[00:18:37] Where, yeah,

[00:18:40] Yeah, like attempted suicides. And oh, I mean, I remember going down to this one that I got a call for. Basically, it was it was bad, and I phoned my senior when I was walking down there and he was like, they said, It’s this and this and this, and I could kind of hear him on the other end. Oh my God. And he just said, Alright, try and maintain an airway, stop the bleeding. And if he dies, it’s not your fault. I was solid, solid advice on best. And yeah, those moments really do stick with you, as is like a not not.

[00:19:23] I think

[00:19:23] You’re right. You know, you can get shaken by that and go, Oh my God. But but other times you look back on it and go, Actually, this this this little bit of left route is probably not too bad, you know?

[00:19:34] Yeah, yeah. And it puts you in good stead. So your next job, you ended up doing quite a lot of ore surgery. Yeah, I can get yes, one,

[00:19:46] Yes, dear one. When I did it in the Rhondda Valley and in a little town called Treorchy

[00:19:55] And in that town, I think I ended up there once at 4am after a big party.

[00:20:05] It’s on me. It was great, you know, relatively low stress, I would say for what you’re what you’re trying to achieve in patients, but were lovely. But at the same time, some of them just like happy to be seen. And. But it was a bit of a reality check. You know, you come out of uni and you think I’m going to do this. So I’m going to I want to try and do the really good root canal. And and I suppose that was a good place to learn that situation of, you know, not everyone wants a root canal. And and I remember someone saying to us, once, you know, try not to care more about a patient’s teeth than they do because you’re going to you’re going to be tearing your hair out. I mean, yeah, all kinds of hilarious characters there, but absolutely brilliant place to learn just so much exposure.

[00:21:05] And yeah, he’s still living in Cardiff at that point.

[00:21:08] Yeah. Yeah, I was living in the bay there with Jess, my now wife. And so it was a nice, little nice little commute. Just drive up up to the valley each day as. 50 odd minutes and living down in the bay was, yeah, good fun.

[00:21:23] So you know that life of straight off the university, you’re still a new university town, you know, you kind of still got your sort of community around you and network around you. Look, I found my next job after that quite quite a bit of change. I felt lonely as a as a, you know, real person compared to the student, you know, nice sort of mix of people on VTi with me. Where did your first real job?

[00:21:54] Well, actually, so do maths facts. I’m sure you found this. You don’t really have any time to spend any money or live a life, basically. So I was earning a little bit, not much, but a little bit more than that. And no time to spend it. And that did my vote year. And Jess basically said to me, which is I’ve never been travelling and I’ve always wanted to. I thought, OK, I said, Let’s go, you know, end of this year, you’re never going to have a break in your contract ever again. You know, if it’s one year, that’s the end of that. And I’m like, Yeah, alright, cool. Six months into the details, let’s do it. We’re going to when we booked it and then I got towards the end. And yeah, towards the end of Beattie, my boss was saying, You know, I’ll offer you an associate position. Yes, I’ve come up with was how many thousands of eda’s and whatever it good money. Basically, I was thinking, Oh, that’s tempting, but we’ve bought this ticket, you know, so. So we did it. We went and best thing we ever did. I remember I was a bit a bit concerned at the time sort of thinking, you know, how am I going to come back and everyone else is going to

[00:23:08] Be way

[00:23:09] Ahead? My stunting, my career progression and whatever. And you know, all these silly things you think when you’re when you’re young, you know, I think, you know, you’ve been uni for five years and whatever you’re fresh out, you want to get going. I certainly did. Yeah, yeah. But we did it. We went, And where did you go? So start off Borneo and Bali for about a month. And then we went down to Australia a couple of weeks, five weeks New Zealand and then month in Thailand and month in Vietnam. And it’s just amazing. I just loved it, you know, and I think that was really good for me to not be so like, I think if I just got straight into it, I don’t know, maybe got a burn out or something, but it was a good slow down a bit and have a think about things. And from there we got we were getting towards the end of our travels and just said, you know, where do you want to, where you want to live? And I said, Oh, maybe sorry. And she said, Cornwall. So we ended up in Bath.

[00:24:10] So many of us were happy then, but then actually just absolutely loved Bath. And I remember sitting in this bar. Oh, amazing city. But we had to sort out flat before we got back. And before we went travelling, we printed off a load of CVS cover letters, and I think I had a few photos put together and we had them all ready to send out. And a month before he went back, we sent them out to every practise we would be happy to work at. I spend, I don’t know, 40 odd in the Bristol Bath area, but I remember sitting in a bar in Vietnam. Just Jess’s parents had very kindly gone to view some flats for us, and they were FaceTiming us looking around the flats. But they appeared to like travel between them and whatever, and we had to keep the internet connexion going. So we were buying these twenty three beers and getting more and more pissed. Looking at these flats, like, that’s amazing. I think we nearly signed up to something on the Royal Crescent through honest, but we got.

[00:25:19] How long were you away for in total? Was it

[00:25:20] Six months? Just under

[00:25:22] Six months? Yeah.

[00:25:24] So you spent all your savings? I’m pretty much what was it, backpacking packing, what were you thinking? From the husband on the one to a six month holiday?

[00:25:36] Do you know, full on, full on backpacking? I don’t know.

[00:25:42] You think sharing with others is that was it was like because the beach is so cheap over there. Yeah, because

[00:25:50] We were to actually like a joint room or shared room with one bed in. It is not it’s not that much more expensive, really. We stayed in a few dorm rooms and oh man, all those places. All those places. But you’ve got a camper in New Zealand. It was

[00:26:07] Amazing. Oh, wow. To do that whole South Island stuff.

[00:26:10] Oh yeah, I did the whole North Island, South Island five weeks.

[00:26:14] Incredible. Incredible. I mean, did you did you think about doing a year off before university?

[00:26:20] No. No, because I think I was really, I wouldn’t say overwhelmed. But I was very aware that like five year degree is a long time and one time actually that it kind of hit me, whereas I came back to Surrey just after we’d had. I don’t know if you had this, but we had like a halfway meal at two and a half years to celebrate getting halfway through the degree of sort of like miserable reminder. And I came back to Surrey and we went I was on a night out in London with just like guys from school, and they’d all finished their degree. I think they’d all just got like their first and second pay cheque and they were like, Yeah, let’s buy this place up, you know, getting the rounds in like, Oh, I don’t know if I can afford the train ticket home like, you know, uni dry patch there and that I found quite tough, actually, because I was thinking, Do you know what? I’m halfway through this degree, and all my friends are like hitting the earning now, and how am I going to catch that up and whatever? And actually then I think that’s when I kind of like solidified into with all the Dental people and whatever, you know, before that, I was living with guys from outside dentistry, which is kind of healthy, I think, for the first few years. Yeah. And then after that, yeah, really sort of got in with the Dental guys

[00:27:43] And tell me about the top in Bath.

[00:27:47] So yeah, Bath, I I got a job we live in in Bath, but I work just outside in a little town called caution. Fairly standard mixed practise. It was like two three surgeries, two associates and the hygienist and I guess it was kind of

[00:28:03] Associate led really

[00:28:04] The the owner. He had a single surgery practise on the circus in Bath, doing pretty much all only implants. And it’s great, you know, it kind of left the Dorian thing. I think I just did enough to keep the boss happy. So ticking over and that’s where I did my implant, MSI, which I couldn’t. I was a bit torn where to go, you know, I think it was like Sheffield London or Bristol, and it’s an expensive course combined with all the time off and everything. I was like, I can’t really decide between them, so I might as well do Bristol. It’s the closest and it just so happens that like pretty much all the clinical days, which is eighty five percent of the course was in

[00:28:45] Bath, about 500

[00:28:47] Yards down the road. So I felt really jammy when some people were like flying from Scotland. I think this lady from like the Isle of Man or something, and

[00:28:57] Anyway, travelling all

[00:28:59] This distance today for one day to take a suture out, you know, and I was just nipping back for lunch. So that was massively convenient. And also because my boss was heavily into his implants, he could kind of he just had an agreement with me that he’d mentor me, which I only realised later was pretty an economical way of doing things because mentoring is pretty expensive. And he basically said, Look, I won’t charge you, but as long as you once you once you get the hang of it, I can leave you alone, basically. So that was great.

[00:29:28] When did you decide? When had you decided to go into implants? Was that something you always planned to do or was it the influence of this boss in that?

[00:29:38] Yeah. Yeah. In fact, I got a taste for it, and then in the vet practise, I was in the good mate of mine, get a good buzz. He was doing implants there and he was about, I think, for four or five years. Yeah, four years ahead of me and uni. And so I could just see what he was doing and whatever. And yeah, it just got a bit of a taste for it. And then I decided when we’re travelling, it’s, you know, when we’re travelling, it kind of gave you a lot of time to think and kind of decide on a

[00:30:09] Pathway, I guess. Yeah.

[00:30:12] And then, yeah, we were there for. About four years in Bath is kind of funny, really how the Cornwall situation came about from being on the MSC. One of the guys, Tim Harris, who teaches on it, is Friends with my now boss, Mark and Mark Davies said to him There are any implant people on your course that would be interested. So he just put out an internal email to the MSC Group just saying, you know, anyone be interested as an implant job, come up in Cornwall. And I was on holiday with my wife and her family, and I saw an email come through and I was like, Oh. I might just enquire, you know, so I put my name down and Mark got back to me and said, Oh, you know, I own pure Dental in Truro Hospital. Oh bloody hell, I know pure Dental like,

[00:31:04] I think very high profile practise, right?

[00:31:07] Yeah. And I thought,

[00:31:09] Oh God,

[00:31:10] What if I put my name in for? And if I’m honest, I just thought

[00:31:15] That’s out of my depth. I’m not going to get that,

[00:31:17] But I was like, Well, you know, you don’t put your name in, you never find out. And I had a bit of an interest in I just I liked taking photos. And to be honest, it was about the round, about the time when you know the sort of Facebook dentistry is really getting going and you could just see these high profile guys posting these cases. I just had that thing in the back of my head of. It’s a good thing to do, you know, build a portfolio. I don’t think any of my I didn’t know anyone else doing that at the time. And so I just sort of thought, Well, I don’t know if I’m getting anything out of these photos, really, but these guys say it’s a good idea, so I’m going to stick it out. And then when it came to it, when on holiday, you know, Mark said, Oh, send me a CV, send me some photos and excerpts of your work. And I was like, Yeah, here you go, ping. Half an hour later, you had it. And he was. I looked great. You know, it’s pretty much yours, but let’s chat in the week when you get back from holiday and which time? I hadn’t said anything to my wife and she’s like,

[00:32:20] Well, you get off your lap, you doing your laptop

[00:32:22] On holiday.

[00:32:23] And I hadn’t told her because I was like, she will be over the Moon to move to Cornwall, but I can’t. I daren’t disappoint her and say, you know, whatever. I didn’t get it. I just turned that around because, you know, I’ve been horribly rude on my laptop. And she said, I just got a job in Truro, pure Dental. But it was for 13 months ahead. So that was a bit tricky. Going back to work and being I got a job in just over a year’s time. Moving to Cornwall and my notice periods like three months, actually actually given four months in the end. But I got within. I was doing a little bit of short term, although then I remember getting within the six month mark, but turning us in case seeing cases like, Oh, it’s a bit complex and I’m going to refer that, refer that to my boss. My nurse is looking at me like, what are we talking about? Like, I could do that. So yeah, that was a bit tricky. But yeah, it was worth it.

[00:33:24] Why was he looking for someone so early? He just a planner. The one thing

[00:33:28] I think it because we may be lazy. I think it’s because because the guy Jeremy Harris has taken over from had, you know, he was retiring, it was a long plan. You know, it wasn’t. Yeah, quick notice. So he wanted to give himself time to to look around. And I don’t know, perhaps no one has applied and

[00:33:50] Was a bit like that. It’s hard to hard to persuade people to come, come and move there.

[00:33:55] So I imagine yeah, I imagine so.

[00:33:57] Yeah, yeah. Well, when you told me Jeremy Harris, I took a gasp because he’s known for doing some huge cases for years that he’s been doing implant ology and full mouth dentistry, right?

[00:34:09] Yeah. Did you feel the same?

[00:34:11] You know, did you did you know him or have you heard of him before?

[00:34:15] I knew who he was, but I had no. I had no idea quite the extent of what he was doing, and

[00:34:23] I knew he had an honour to take over that list. Really?

[00:34:26] Yeah, a real honour. Yeah, I

[00:34:28] Mean, sometimes now even, you know, oh, unclip a chrome dentro, just like, have a look for a bit, you know, and

[00:34:35] Sit down there and

[00:34:37] Was this attachment and then, you know, patient breaks the crown and they’re like, Oh, you’re just going to do, you know, sort this out and you’re like, Oh my God, this is this is complicated. And so, yeah, really real honour, real

[00:34:50] Honour and a steep learning curve, I’m sure.

[00:34:53] Yeah, for sure. But because I had such a long time knowing I was going to start there, I remember I remember halfway through Max being like, I’ve hardly placed any Canada’s. I’ve been bottling out of it and letting all the nurses do it. So the last six months of Max, I’m going to pace at least five years a week for the rest of this. And so when I got that one year, you know, ready to go scenario, I kind of was, OK, I’ve got this job that I can either just like bury my head in the sand and try and survive it, or I’ve got 12 months to try and just nail the basics. And so pretty much from then on, I was like, Right, I’m rubber damning. Everything I’m going to make, take all the time in the world and have it go all this and just upskill as much as I can. I’ve probably made hardly any money that year, but. A long time on treatments and just try to get confident in the basics, you know, and so when I when I went to Pure, I was like, Great, I’m just going to, yeah, I’m rubber dam and everything. I’m happy with my crown preps and whatever. But the one thing Mark said to me was, You know, I like your portfolio, but it’s a lot of single single tooth density or small cases. And to work here, you’re going to need to understand full mouth, which is kind of daunting. But he said, Look, you’ve got to go and do Dawson go to the Dawson Occlusion Academy. He absolutely lives and breathes Dawson. And so if I’m honest, I we didn’t. We didn’t have a lot of occlusion

[00:36:34] Lectures at uni

[00:36:36] Or if we did, I don’t remember them particularly well,

[00:36:38] But I

[00:36:40] Had no idea what I was getting myself into go into to Dawson. And when I looked at like four modules of like three days each night, what is going on? And I sometimes find when I talk to my friends, whatever

[00:36:54] Is, you know, how

[00:36:55] I got interested in occlusion. Like what? What do you mean? Like, tap together and look at the blue dots here? And was

[00:37:03] Like, Yeah, but I think I think a lot

[00:37:06] Of people that don’t necessarily or haven’t done those sorts of courses don’t link occlusion with being able to do format rehabs and big treatment. I don’t know. I think you’re right. And actually, you know, this like study of occlusion is not about nerding out over the TMJ. I mean, yes, you end up becoming that person because, you know, just do anyway. But it’s about treating a whole mouth. And yeah, that was a huge game changer, really. That course for me, Alan,

[00:37:39] I look at your content. A lot of it is that sort of biomimetic sort of, you know, the rubber dam, these sort of protocols and that aspect I’m keen to know about, you know, the role of social media in the development of dentists because it’s very it’s very sort of fashionable to put it down. But I’ve definitely noticed that since social media dentistry has come along, the standards of young dentists, which just gone through the roof.

[00:38:13] Mm hmm. Ok.

[00:38:15] You know, it could be self-selecting and the ones I’m meeting or whatever it is. But but the standards are high and I want to know,

[00:38:22] You know,

[00:38:24] The other side of it, you know, but it’s all it’s very easy to say it’s rubbish. And you know, all the things that we know is wrong with Instagram dentistry and all that. But but what role did it play in your development as a dentist?

[00:38:37] And so, Alice, I started my Instagram account when I moved to Cornwall because

[00:38:42] That before

[00:38:43] Then I’d been taking my photos to get that portfolio together to get the private job. And I’ve got this job that was, you know, a huge leap up in what I’ve been doing. And I thought, Well, I’ve got to take photos for now, but know I could just work this job. And so as I do, I’m going to start with these Instagram accounts and it would just make me take photos. I’m going to post the case a week or whatever I decided to do. And that’s literally how I got into it, just to try and keep myself accountable, really to to taking photos and sticking at something that I’d kind of decided was a good idea and actually what I found more recently with Instagram. And I think this is where Instagram and Facebook differ, is that if you are a dentist that posts for dentists and you’re trying to post quality content or educational content or

[00:39:39] Whatever, like, it’s pretty

[00:39:42] Hard to post a lot of content, even like one a week is is time. And you know, there’ll be cases where you take take photos and you run out of time to take any more photos or it just doesn’t go well or whatever, you know. So I think for me, sometimes I’ll be in work. I’m like, you know, I’m photographing in this case, it drives you to push your your quality, for sure. I think I feel on Facebook because you’re in a big group, you only have to post, I don’t know, one case a month or whatever to stay relevant. You just got to keep your name in the hat, whereas in Instagram on Instagram. Yeah, it’s a really positive platform. There’s a lot of back slapping, and that’s cool, but you’re the only person on your page, and so you’re the only one that can keep your content going and drive it. And I guess I guess more recently, I’ve kind of flipped more towards like posting more stories and trying to keep just complete quality for my page. And also, I really like that interactive story part where you can I talk people through a case and I find a lot of people really resonate with that. I get so many nice messages like, Oh, thanks for explaining how to do that. And you know, I I definitely learn huge amounts of social media, Facebook and Instagram. You just got to be selective and careful and like, learn kind of within your limits, you know?

[00:41:10] Yeah, yeah, so so that’s kind of what I was asking is, you know, what you’ve learnt, where you’ve learnt it, which accounts you’ve learnt it from, you know, for instance, for me, someone like George Cheatin, you know, I’ve learnt so much from that guy just by looking at his Instagram. This is amazing. Yeah, yeah. And you know, I’m not even practising.

[00:41:33] But for me, it’s actually

[00:41:36] I know it’s good content when it makes me want to try the damn thing. I saw one of yours. You were using the tool. Was it you the thing? Oh yeah. Yeah, yeah. And, you know, the Liquid Dam is reporting that this is so obvious, right of this thing. But but maybe I’ll call and try that now. And it’s a lot better than the kittens, right? But but it does get a bad name as well. And and I think a lot of the bad part of it is when it’s aimed at patients and people aren’t taking care of, you know, anything other than trying to track the patient to them. Hmm. Did you have the did you have ever wanted to do a patient facing page because you’re definitely isn’t right?

[00:42:27] Yeah, it’s not. It’s not. I’ve had I think I’ve had one patient

[00:42:36] And they

[00:42:37] They came in, you know, it’s hilarious. Actually, I treated them last week and I came in and I said, Oh hell, I always introduce people to the rubber down its first filling appointment, and I said, Oh, you see one of these before? And she’s like, Yeah, on your page,

[00:42:53] I was like, All

[00:42:54] Right, cool. So that’s fine. We’re going to do this. So you’re going to tie some floss around it. No, but I feel like I should know. So, yeah, I mean, you were asking about influential pages, and I would say for sure, you know, Lincoln Harris on the right page, just the amount of quality content that God puts out that I’ve learnt huge amounts from from him. But for me now, it’s more about the little tiny things that you pick up, perhaps on a case you you’ve already done or you know how to do. But they’re doing it. One little step is different. And that’s that’s where you can just tweak and refine and you make these tiny, tiny little steps. And then you look back a year later, you’re like, Whoa, I’ve come a long way. But combined with that, like the the networking is is mad, and that’s something I’ve never, I don’t know I’ve never been good at. I never really had any intent to be involved in, you know, not not chatting to people like schmoozing people, I suppose, you know, it just doesn’t come naturally to me. But on Instagram, you start chatting to people and all of a sudden you know your chatting to people around the place. And that’s how I got to know guys like Chris O’Connor, who owns its Dental and yeah, chat to Georgia dentists every now and again. I’ve spoke to him on the phone and stuff, and especially down in Cornwall. You know, I don’t get to meet, meet and greet and, you know, go to those nice parties that I see online.

[00:44:40] I’ve spoken. I’ve worked a lot with Jason Smith and I’ve spoken to him about the Cornwall as a as a place to work and live. And there are the obvious advantages, right? But but there is that thing of if you want to fly to

[00:44:54] Portugal,

[00:44:56] You’ve got that whole journey before getting to the airport and then back.

[00:45:03] That’s funny. You said Portugal. Portugal is pretty much the only place you can fly from the UK and it’s like 40. Is that right? Is that

[00:45:10] Right? Yeah, I know you’re going to Portugal a lot. Yeah, but oh,

[00:45:19] Do you know what are so, so naive to that? As naive to that because

[00:45:23] I,

[00:45:24] You know, I grew up in Hallie, which is a £5 taxi ride from Gatwick, and I had no idea. But even living in Bath, you know, getting to Bristol Airport, I like this. This is a pain. I can’t. I can’t believe people put up with this. You know, they’ve got a

[00:45:39] Commute to the airport as a ticket.

[00:45:42] But now I’m in Cornwall two hours to anywhere, you know, get back to the the rest of the world, you get to Exeter. It’s like God, I’m only just starting. So yeah, there is that. There is that. But at the same time, you kind of having this sort of slightly more isolated situation. There’s perks to it, even in in work as well. You know, you’ve got this little community, a dentist that you can easily interact with, but at the same time, you’re not you’re not all fighting each other. There’s a lot of people down here, a lot of teeth, not that many dentists. So there’s more than enough work for everyone. And and that makes for

[00:46:19] Sort of

[00:46:20] Quite nice work environment as well.

[00:46:22] And your patient group, I know Truro has, you know, both both sides, hasn’t it? It’s actually a lot of, you know, didn’t need down there as well. But your patient group? Is it is it that sort of typical person you’d imagine who’s like retired to Cornwall and this time wants to get his teeth right? Is that is that it? Am I talking rubbish?

[00:46:48] Yes and no. Yes and no. So when I when I moved into this, you know, it’s high end private practise, I was like, OK, I’m going to have demanding veneer patients all day, every day, and I’m just going to see how it goes. And actually, it’s just not the case, I would say. I say my patients are probably three different categories. One would be what you would expect in private practise. You know, they want the best, and that’s fine. Some of them are great. Most of them are great. Some of them a bit more fussy. Then you’ve got phobic patients who basically just need time. So many of them. So I’ve done sedation training in the last few years, but so many of my sedation patients, we sedate them initially and I try and win them off it. That’s kind of my goal, and that is life changing treatment. I have a guy who he wouldn’t let us take photos even in the waiting room, he cried, Come on up the stairs the first time he ever came in and he wouldn’t sit in the chair. It was traumatic just for him to come in the practise. We did a fair amount treatment under sedation and then a couple of months ago we placed two lower implants and with no sedation and us and fulfilling. Isn’t it so good? So, so good. So, yeah, phobic patients. And then lastly, it’s like people who haven’t been in 20 years and they just they just come in and go. My teeth are wrecked. I’m going to pay for it. Just do the do what you can or do you need to do, you know, because they they they get there’s limitations with the system. They know they’ve got a lot of work to do and they just want to get it done. And some of those are fantastically rewarding as well. So, yeah, it’s not all difficult.

[00:48:28] So, you know,

[00:48:30] The kind of work that you do now, there’s quite a lot of full mouth stuff there, right? And you’re actually carrying that out now. Yeah, the conversation for the patient that comes in with, let’s say, Problem X, I mean, he might do probably he might come in saying, my front teeth are looking short. Yeah, or or whatever it is, my back is broken. Yeah. And then and then you have a look. And when you’re looking at things from that comprehensive sort of mindset, you might then turn around and say, you need. Thirty thousand pounds worth of treatment. Have you have you sort of figured out some ways of breaking that news in a sort of a piecemeal way to, you know, how how do you communicate with the patient to give them that news? Because, you know, I’m thinking, I’m thinking of my brother. My brother has a mutagenesis imperfecta and he has a full mouth of crowns. He should know better, right? He should know that when he goes to a dentist, the dentist might say, you need a big dream. But I remember my brother came back and say, the guy said it would be like 10 grand. And I said, Well, he might be. I haven’t seen him myself. How do you how did you break the news? What do you do? Tell me about it.

[00:49:44] So a lot of the time I find those patients come in and they’re like, I know it’s bad. They’re really they’re really bad ones. Say, for example, I find I find actually just slightly that some of the tooth wear cases where they don’t really know they’re quite tricky. They are. Yeah. Okay, so those ones. So my standard new patient assessment, everybody gets a set of radiographs that they need, usually set by a full set of photographs. We do the assessment and then we get out the chair, go and sit by a monitor in the corner and we talk through their photos and even the people with the nicest teeth. You put their screen on a T on a 40 inch monitor and they go, Oh my God. And so you’re instantly getting them to see the problem because you think that sounds mad. They know what’s going on with their teeth, but they don’t. And when you can actually show them. So, so let them see what’s going on is my first thing to do. The next thing is, and this is new, I don’t haven’t always done it this way, but now it’s how I always do. It is our stage people are. We’re going to take this in two stages. We’re going to do a stabilisation phase in a definitive phase and stabilisation is get your gums healthy, fill things we can fill, take out anything we can’t and get your maintenance on board. And some patients, that is a six month journey. You know, it depends on how often they want to come in, but other patients are like, Yeah, let’s do it, let’s nail this and other patients that come in every week for two months and just, you know, tidied everything up. They’ve got caries everywhere and whenever and and and then I say to them, and that’s going to end with a planning phase

[00:51:32] And

[00:51:33] I say, Well, you know, if you’re going to build a house, you wouldn’t just start putting bricks down. You’ve got to get the architect in first. And that’s where we’re going to start. We’ve got to do a plan for your mouth and talk to them about their bias a little bit. And usually they start to, you know, they see what you’re doing, you know, for example, they come in for this first film. I never started anything major. It’s like a little clues or on a six or something to start with. They come in.

[00:51:59] You treat them

[00:52:01] As you would anybody but to your best ability. You know, given topical, we’ve got a TV on the ceiling. I’m using rubber. Damn, it doesn’t hurt. They don’t drown with the water. The filling looks nice. Sometimes they have a little snooze until the rubber dam. If you really winning and they sit up there like that was all right, actually. And then, you know, sometimes they’ll go, Oh, it’s so look like on the photo and you showed them and they’re on board. They’re sold. They they’re like, OK, I feel like

[00:52:32] This guy

[00:52:32] Gets it or whatever. And then you get to the end of the stabilisation and you say, Do you want to do the planning? You know, this is a treatment plan for that going. Record your, your teeth, your bite and your jaw position. And I’m going to go away for six weeks with the technician and we’re going to plan your case in the background and then I’ll tell you what’s involved and they’ll get a wish list from them. And quite often, I’ll ask them if they have a budget because by then they’re starting to get the problem. You know, you touch on it a couple of times and you can. By doing a stabilisation phase, I find that you can really draw out people what they think about their teeth or what they hate or what. And you can go back to that of this is what I want to do to your teeth to fix them. And this is how it’s going to achieve your goal. You know, that’s that’s kind of my approach, really, but it’s always difficult. You know, I’ve had people I’ve had, I’ve had several people. We get into stabilisation. We’ve even done the planning phase, which is not for free. You know, we sit down, we show them a full mouth wax up and they go, Yeah, yeah, I’ll think about it and never come back. That’s OK. I’m OK with that like good cause they’re stable. And that makes me feel good because I know they’re healthy. Like, yes, they haven’t got the perfect bite, but they’re a heck of a lot better than when they came in. And I think I would feel a little bit maybe uneasy if I went, OK, here’s the here’s everything it’s going to cost. Yeah, and 30 grand and then never come back and I’ll go back. I. Scott Carey’s everywhere, like we could have at least sort that out.

[00:54:06] Yeah, so I guess you’re saying you use the stabilisation phase number one to get rapport. And number two, to understand their goals. And I guess they’re all hygiene. And you know, you get to know her mouth in a way isn’t, you know, the person. I mean, I’ve had right here

[00:54:24] On this podcast and you

[00:54:26] Know, he told me he sometimes does three examinations before starting treatment. And much of it is for him to work the patient out and to know whether that’s, you know, someone he’s going to work on with him. Sometimes it’s two years of of work before that final fit visit. Yeah, yeah, yeah. What about the actual work? I mean, you’re doing so many different things. I mean, the only part of your work that I can kind of relate to is the composite part. I mean, I know you did maybe a little bit of bleaching too, but the the buzz, the buzz of, I guess, with the full mouth cases, the buzz of everything fitting together, right? Marcano sort of buzz. Yeah, that was it.

[00:55:11] Yeah, there is that there is that. I think I’ve had several times where I’ve thought, you know, you often hear people talking about saying, you know, niche down and, you know, find your area and nail that. And I’m like, Yeah, I’m going to do that, but I haven’t found my area. You know, I I keep enjoying bits,

[00:55:29] And I wasn’t that

[00:55:30] Sure about dentures, and I had a few that didn’t go very well. So I went and did a course with Finley Sutton and I was like, Oh man, this is so good. And so now that didn’t really help me, though, because it just meant I’m doing more stuff now. We’ve got a great practise. Graham, it does end, though, and so I might just not even going to bother with that. Why? Why try when he’s already nailing it? So but apart from that, I just enjoy it. Oh, really? And it’s yeah, it’s how it fits together. But it’s getting I get huge satisfaction when I’m doing a crown Prav. I’m like, Man, that’s that’s crisp, you know? Or, yeah, a few composites and even all the little bits, you know, not just pretty anatomy, but a good contact point and all the bits that go with it. Just I find it really like just personally satisfying. And I think that’s why I struggle to. Some people would say, Oh, you know, you can try and do everything. I think I just a bit of a dabble, really and and

[00:56:31] Just

[00:56:32] I can’t inside.

[00:56:34] I can’t decide. I think, look, the most important thing is that you’re happy that it’s the most

[00:56:38] Important thing now.

[00:56:40] So as long as you’re happy, that’s it. But but I think I don’t know. To me, it looks like you’re going down the route of being a teacher of some sort. I mean, you’ve done some courses anyway. And it’s an important question, right?

[00:56:56] Should you teach

[00:56:57] More than one subject? And I think you can do. I think you can. You could. You can teach isolation, you can teach composite. You can teach,

[00:57:05] I don’t know.

[00:57:05] Can you teach in parts that probably some aspects of it, right? And you know, I have this conversation with Dipesh a lot. You know, Dipesh Palmer, yeah, he’s very talented in lots of different areas. And then the question of, you know, is what’s what’s the someone like Newton file like at implants? I don’t know if you’re going to be a teacher, you’re going to be a year course teacher. It sounds like because there’s so many different parts of dentistry that you’re interested in, isn’t it?

[00:57:40] Yeah, I don’t, you know, I don’t know the teaching thing for me.

[00:57:44] Just like it just happened.

[00:57:46] I didn’t. I hadn’t. I have no desire to to to teach and, you know, show off my skills or whatever. I just I really enjoyed teaching, actually. And yeah, when we ran the course this year, the first one we did was in, well, we actually set it up to do the first one in Newcastle and then the dates so happened that it failed, that the Baath course was going to be a month before we were like, Oh crap, we better get a move on, like our start date just moved a month forward. And so we’re doing this, this composite course with myself,

[00:58:25] Chris

[00:58:25] O’connor, who owns Incidente. When a guy Olly Bailey, who’s a friend of his

[00:58:30] Works up

[00:58:31] In Newcastle with him,

[00:58:32] A fantastic clinician

[00:58:35] And I’ve never met either of them. I chatted to Chris, seen him on Zoom, Zoom and Zoom a few times and we were kind of on the same page or whatever. I sent him my lecture and he was like, Oh, put it all together, and I had never given a lecture. I think, I mean, yeah, I don’t think I’d ever given a lecture in front of like dentists. I mean, I’ve done, I’ve done. I’ve done a 30 minute presentation at uni. Imperio the I knew nothing about, and I did I did a rubber dam webinar in lockdown, which I just I really enjoyed it. I just liked that kind of just telling people like This is what I do, and this is difficult. This is how you can make it work. We went to this course and that’s like, I don’t actually know how you can practise a one hour lecture. You can’t practise two days. So I spent like, I know what I’m going to say, but I don’t know how long it will last. You know, is this enough for two days? Yeah. And I basically planned what was going to say on the first slide and everything else. I knew all the other slides, I knew all the pictures there. My case is a new kind of the topics I wanted to cover, but just pretty much freestyle the rest of it because it was just talking about what I did every day. It wasn’t like, OK, I’ve got to have all these papers to back up this, I’m saying and whatever and defend yourself. Yeah, yeah, exactly, exactly. And yeah, I really enjoyed it, and it seemed to go fairly well. So that was my like kind of first experience with teaching, really. And yeah, happy to continue it. It was really good fun. But yeah, I’ve got no major plans to set up the HILLENBURG in one year course in, you know, whatever you want to pick out my Instagram page.

[01:00:29] But do you see this? You do see what I mean by confidence, right? I mean, the next man would have said, Well, I’ve never talked before. I’m not up for this. I’m not going to do this. Or, you know, or or it wouldn’t have gone so well, but it just jumped into it and did it.

[01:00:43] Yeah. But the thing was, I was a bit like, if I don’t say yes to this, you know, when am I going to get an opportunity to teach a course like this? It’s just not. It’s just not going to happen, so I thought I

[01:00:53] Heard they picked you up from your account, your Instagram account. Is that how it happened?

[01:00:58] I think so. Yeah, kind of be kind of. Yeah, so I mean, I got chatting to Chris on on Instagram. I asked him a question. I think that like drew us into this funnel of nerd occlusion chat that he’s like, I like, he’s like,

[01:01:15] This

[01:01:17] Is guys as sad as I am, it’s Saturday night and he’s still messaging me. And then actually me, Chris Jaz Gulati. A couple other guys, my buddy Vijay and Richard McIndoe just started a

[01:01:32] Little online study club

[01:01:34] Just out of the blue, and we each that was it. Actually, we each gave a lecture on that and I said I’d go first and I gave a lecture on suturing, which I just wrote from this sort of advanced soft tissue course I’d done, and they had this really amazing bit on suturing. And so I told everyone, Right, you’ve got to bring you’ve got to you’ve got to bring a suture kit, some some sutures and a banana and a scalpel. And we did this suture lecture. And Chris, he’s like, I don’t do any suturing, but I’m so into this now. And that was basically that’s what I think where he went, Hey, let’s do. That’s what he basically said. Let’s do something together. It just came from there.

[01:02:17] All right. I’ve never done this before, but I’m going to try it this time. Yeah. I want your Altenberg in three top tips. I’m going to I’m going to fire the subjects. Okay? And I just want you to just think too much about actually to fire out your three top tips on rubber down

[01:02:32] Through a rubber down start. Easy. Don’t throw yourself in at the deep end. It’s just stressful. Give yourself time. Plan a little bit of extra time and

[01:02:46] Something practical and practical.

[01:02:48] Give yourself space when you’re isolating. So if you’re going to treat a lower six isolate camp, the seven and isolate, at least to the four 14th isolation is like my standard quadrant.

[01:03:00] I mean, suturing three top tips

[01:03:02] On suturing,

[01:03:06] You

[01:03:08] Get careful.

[01:03:15] Take your time to get in position. Don’t be bending over backwards with your arm twisted just to try and get the suture in place, move around, get comfortable and move the suture within the holder to get it in the right place so you can sit comfortably with your first throw. Get the not to lie flat and then what?

[01:03:38] What, what? What’s going on? Say that?

[01:03:43] Explain that. Okay, so when you’re tying your suture, they say you’re using a four 000 vehicle resizable suture. You’re going to throw the needle by. So wrapping around the suture holder and then you going to pull tight. That’s your first throw. You’re going to pull in the direction

[01:04:03] That the needle

[01:04:05] Went through the tissue. And if you’re not sure what if what you’re supposed to look like, the knot should lie flat, okay? And if you have it flat against the government and if you’ve ever done this, it will look like it’s wrapped over each other. Not like a little ball. Yeah, that’s how you get your suture tight. And then the second throw ties tighten that locks the first throw and you can’t rectify it with the second throw. You can’t do a crap job on the first one and then save it on the second one, pulling it really hard. That’s that’s basically the

[01:04:37] Crux of it. And much of much of successful implant ology

[01:04:42] From the aesthetic sort of

[01:04:43] Perspective. Suturing is a massive part of that, right?

[01:04:46] Oh yeah, for sure. That’s why I love it. I just I find it really quite sort of relaxing, you know, at the end of the procedure. I used to I used to be like, Oh man, get this wound closed down stress. This was a hard case. Now, like, OK, let’s chew. Let’s close this up. Let’s put some nice sutures in and relax a bit.

[01:05:09] Three top tips on composites. How many top three they it’s your fault for being good at everything. So, so

[01:05:21] Good. So one comes by Oh man, so many of them. Yeah, yeah. I would say take if you do a class to take your time to get your matrix, whatever you’re using, set up in place and the rest will be quite straightforward. Don’t just rush that bit and then be like, OK, now I’ve got to sort this mess up. Use a good bonding system, so I’m an optic bond AFL fan. You know, there’s decent self etched pieces out there, clear feeling that sort of thing. But do you use a decent system and know how to use it? So we do a little seminar in the course. It’s like an hour section, which Chris does, and it’s

[01:06:12] I’ve seen him to

[01:06:14] Four times down, I think, and it’s just brilliant. He goes through how, you know, basically what you’ve got in the drawer and how to use them differently.

[01:06:23] Yeah.

[01:06:23] And and isolate it.

[01:06:27] Yeah. Read the instructions, right? So many people don’t read the instructions. Yeah, sure. It’s interesting for sure. I wouldn’t worry

[01:06:35] About running out and running.

[01:06:39] I want to. I want to move on to darker days. We ask everyone on this podcast this question. It’s around either something you did that you later on regretted doing clinically or, you know, your most difficult patient, the most difficult management patient, something we can all learn from that. Hmm.

[01:07:03] I would say and this is so earlier I said about my sort of stabilisation and definitive phase, and I said, I haven’t always done that. And I got a little bit burnt once with a tooth wear case. There’s a composite rehab. And I did the full wax up. Lovely lady and plan the case. And I said, Look, you’ve got these two crowns on your Prav molars on the left. It would be ideal to replace them at the same time to get your bite right and to make everything look the same. She was like,

[01:07:44] Ok, well, I get that.

[01:07:45] That’s ideal, but it’s a bit out of my budget. So that’s fine. I can make it work. That’s no problem. But we just needed to, like, discuss that first. There’s a few other little bits. So we did the composite rehab and there was a situation. I can’t think what it was, but basically she saw a colleague of mine at a review and she she said a few strange things throughout. But she she said to my

[01:08:12] Friend Alan tried to

[01:08:13] Scratch these crowns on purpose when he was going around the composite because he wanted me to replace them because he wanted me to spend more money.

[01:08:21] And, well,

[01:08:24] The guy I was working with, he’s a legend. He doesn’t, he lacks a filter. And he said, OK, so

[01:08:37] So crowns

[01:08:39] Are crowns are glazed in a furnace when they’re made. And that’s the only way to get a glaze on them. So I’m going to have a look at your mouth in a minute and. If the guy is damage, then then Alan, scratch those crowns, but that glaze is in intact, then then you’re lying there like, just check it. Yeah, have a look. So we had a look just he struggled with. I don’t know what to say, but that glaze is fine.

[01:09:19] And he just sat in silence and stared

[01:09:23] As she said she went, she she didn’t lose it, but she was

[01:09:27] Like, No, he did it. He scratched them.

[01:09:29] He tried to do so. She complained. She went to the boss. So now she’s requested to see, see the boss. And you know, I’m thinking, Oh, did I? The polish that margin perfectly on the concept, you know, we see each other’s work, but you know, it’s not common that he’s going to like, inspect it like that and pick it apart. And he had a look and he just said, really sorry. Like? I worked, it works great. There’s nothing wrong here. He said, I’ll

[01:10:00] Pay for you to

[01:10:01] Go and have a consultation anywhere in the county. We’ll pay for that. Get a second opinion. And it went on and on and

[01:10:10] She kind of

[01:10:11] Came to see me and I was like, Oh, got some alarm bells going here? This is just getting out of hand. And in the end, I just sat down, had a chat to my boss and he’s like, Look, I think we should just refund her and cut our losses or whatever. And you know, it was a five to five composite build up case upper and lower. It wasn’t a quick fix, cheap treatment. And I said, Yeah, let’s do it. Which gave all the money back and said, Don’t come back. And that was like afterwards I was reflecting on it with my nurse. I just said, You know, how do we how do we avoid that? You know, how do I? I didn’t see that coming. And it’s because I didn’t know I didn’t know her, and I probably would have picked that out of her in a stabilisation. The tricky thing is, I know everyone needs stabilisation. You know, if they’ve got a clean mouth and a bit of teeth where there’s not like you’re going to do a load of, you know, composite. So in first, maybe do a bit of whitening and slow things down a bit. But yeah, now I I definitely have a more like if I get a gut feeling or whatever. Yeah, I try and slow it down a little bit, get to know the patient for sure. And some of the some of the former rehabs now that I’ve finished are just on the loveliest patients and I’ve got one in next week that we’re nearly finishing. I’m I’m looking forward to seeing her. She’s such a good patient and we’re super busy at the moment. Hopefully remains beer and I just feel like, you know what? Life’s too short to ruin your day with those patients. I’d much rather

[01:11:46] Say I’m sorry, and sometimes I

[01:11:47] Just sometimes I to say this is too difficult for me or

[01:11:52] Whatever. It’s a difficult it’s a difficult one, that one, because when you explained it to me, I thought, Well, there must be a juicier story than this, but she’s questioning your integrity there, not your not your actual work. And so I could understand how that must have felt very strange. Hmm. And you’re right. You know, not not knowing someone is is the best. I mean, for all we know, she’s a paranoid person and questions everyone’s integrity, right? But but you know, when when you look back on it, that’s that’s where you figured things could have been improved insomuch as you didn’t know her long enough before going into something?

[01:12:31] Mm hmm. I think that’s one of those one of the things. It’s probably one of the sort of my weaknesses, I suppose, like I was really disappointed in that, you know, I was really sort of like, Oh, I would never do that. So it was disappointing that someone would think that. But you know, you live and learn and hopefully dodged a few of those since then.

[01:12:53] What about with implants? You must have had some situations with implants.

[01:12:56] No, actually. Yeah, yeah, I had one. I had one where I was doing a sinus lift, and it’s like it was annoying. It was six and a seven, and the seven needed just an internal sinus lift like some style. But, you know, just crystal and. I’ve done the six, I was really happy with the position of it, and then the seven I went to do, I perforated the sinus. So annoying. And then I looked at it and I sort of weigh it all up and I decided to close rather than do a lateral window and try and fix it. I think I’d already placed one implant in the procedure was getting on, and it’s quite a big toe. I’m going to close. And then I left it to heal and then went back to it and it just had real. It is just impossible to then get those two implants parallel in the right place. And I know it sounds really minor, but it’s just it was. It was a. The patient didn’t really notice and it was compromised. But that’s something I find really difficult with implants is that, you know, composites, crown preps. You can like, tweak and tweak and refine. And and if if it’s not perfect, well, you could do it again. Implants, I really find the I think, you know, that sort of perfectionist side.

[01:14:26] I find that

[01:14:26] Difficult to when you get not even complications, just like, you know, someone doesn’t heal as you’d expected or you do a roll flap, you don’t get as much tissue out of it. Why didn’t that work as textbook? And that I find really frustrating. But maybe that’s just an experience, and I’ve only been doing implants right now for four or five years or so. Yeah, that’s that’s one of the difficulties in implants for me.

[01:14:56] Yeah. Well, it’s much less predictable is there. And as soon as you bring soft tissues, then it’s much less predictable. And you’re right, the finality of that placement, you know, once it’s in, it’s just full.

[01:15:08] Yeah, yeah.

[01:15:09] I mean, I had another one, I had another one. There was another central.

[01:15:13] She’s a smoker, but she quit.

[01:15:16] And I don’t know, just the tissues just did not hear well. It’s slightly slightly opened up a little bit on healing and she got she got more recession that I’d anticipated. And after I was like, Oh, maybe I should have done different flap design and blah. And she came from London and she’d seen some. She’d seen Richard Lee in London, top guy who actually went to go see actually a few months back before he moved to New Zealand. Just the loveliest bloke. Top, top dentist. And she used to be seen by him and she said, Oh, look, maybe Richard. So you basically had the implants fine with grafting and stuff. But she had some recession said. So maybe, maybe Richard can do something about it. I was like, hopefully.

[01:16:09] So I messaged

[01:16:10] Him was like, Hey, man, do you recommend it? He’s like, Yeah, go and see Sanjay down the road. So I messaged Sanjay, and it’s difficult. And I I don’t know. Yes. And he said, Yeah, yeah, and I don’t know. I don’t know these guys. Okay, yeah. But I didn’t know him, and all I had was on Richard’s word that this guy’s a good guy. And he end up calling me and I sent I sent the case over and all this. I sent the radiographs over and he called me, Oh man, is he going to say, like, you’ve really balls this laugh or whatever? And he’s like, Mate, I think you got unlucky. He’s like, It looks good. Your implant positions nice and blah blah blah. I think you’ve gotten lucky with the healing. I’m like, So glad you said that. But it doesn’t really help that he’s like, Yeah, I can sort this out. Like, don’t worry, she didn’t go and see him in the exit. It cost him whatever she want to go down there. And actually, I’ve been trying to get back in to finish it and put this

[01:17:06] Permanent crown on.

[01:17:06] But she’s she’s like, she’s so she looks like, Yeah, it’s cool. The temporary looks great. Yeah, but it’s not meant to be on as long as it is. Just come back and finish it. So I don’t know. She’s not too upset about it, which is kind of unfortunate.

[01:17:18] I’ve we’re at to close it out soon, but I want to find out your plans

[01:17:24] For the future.

[01:17:25] Is there going to be a dental practise down the line? Are you happy as an associate? Are you thinking that way?

[01:17:33] I think I’m happy as an associate. You know, I just I don’t think you can do it all. And for me, like the move to Cornwall, so I don’t work Mondays and that work life balance is like everything, really. You know that not working the Monday? Yeah, sometimes I’ll work like do some lecture staff and whatever, and I do stuff in the evenings and

[01:17:59] Yeah, whatever.

[01:18:00] But like if I had a practise, something else would have to give.

[01:18:04] And and I don’t know,

[01:18:08] I love people, but doing it for like dealing with people, you know, I’m not very good in conflict. I think I’d be too soft. I think I’d just be like trying to be the one’s mate.

[01:18:22] Yeah, that that is me too. I’ve got a partner who handles. Yeah, you don’t have. You don’t have to do it all by yourself. You could have a partner. Yeah. Practise manager or whatever. You know,

[01:18:34] Maybe one day, I don’t know.

[01:18:36] So, you know, you’re one of the sort of the people I look at and how many years post-graduation are you now?

[01:18:42] Nine, twenty twelve. Ok, just come up to ten years.

[01:18:47] Yes, if the way you’ve.

[01:18:49] It’s so funny, isn’t it, because if as a as a Dental student, if I told you, yeah, 10 years qualifying, there’d be a guy sitting here saying, you know, for your early stage in your career, you’ve done really well. You think you think, what the hell is he talking about? But then once you get into it, you realise stuff takes years to learn, right? Yeah. But yeah, so for you, for where you’re at 10 years out, it really it’s impressive to see what you’ve achieved. Thank you.

[01:19:15] I appreciate that.

[01:19:17] No, it is.

[01:19:19] Listen, let’s

[01:19:20] Finish it off with Prav know not with us, but perhaps final questions. It’s a bit it’s a bit dark on your deathbed. Yeah, your nearest and dearest around you. One of three pieces of advice you’d give them.

[01:19:39] Um. I think I’d say don’t chase the money. Like. I know a lot of it and a lot of times people say about, you know, you’ve got to enjoy your work, but also like not I enjoy it, but also just do it to your best. And that’s that’s I don’t know. I’ve tried to do that. I think just try and just do the best and the money will sort itself out eventually, hopefully. So, yeah, don’t don’t don’t chase the money and make

[01:20:13] It a quick buck.

[01:20:16] I think just also be to be honest with people like, you know, I think life gets difficult if you’re trying

[01:20:24] To

[01:20:26] Cover things up or, you know, just just be honest with people throughout, and things should be a bit easier. And and I think maybe like, yeah, something that’s fairly new ish to me, but just try and try and get a work life balance like it’s not all about about the work. And I guess looking back about like when I came out of uni and max backs, I’m like, Yeah, let’s hit the ground running. And my wife is like, Yeah, let’s go travelling, chill a bit. Yeah, great. That worked for me. And now we’ve moved to Cornwall and

[01:20:57] I’ve got to got that extra day

[01:20:58] To spend time with family

[01:21:01] Just to get that

[01:21:01] Balance. And and you know, it’s all about being happy, isn’t it? Really, it’s not about

[01:21:07] How do you find it as a dad, as a new dad? It’s tough, isn’t it?

[01:21:12] I love it. Do you know last week was 16 months old, my little boy, Jamie? And last week was the first time I opened the door and he just said, Oh, daddy’s home. And he came running to the door like with his arms out, like, Oh,

[01:21:28] This is so good, you can’t be that. Yeah, yeah. The final final question. It’s kind of like a fantasy dinner party, though. Okay. The dinner party, three guests that are alive. And.

[01:21:52] I think the thing I have, James, that he Castor, I really love that guy is so funny. James Acaster, he’s a he’s a comedian and OK, oh, you should check him out. He’s just the American knows he’s a Brit. He’s a bit like 8:00 a.m. Yeah. He’s like a friend is like a bit like Josh Widdicombe. He’s just like an awkward Brit.

[01:22:14] Secular sickens

[01:22:16] Me. Who else? Maybe Clarkson, I reckon he’s an eagle, he’s got some stories that you know, are not allowed to be aired on TV. Yeah, yeah. And oh, good, three, maybe I should have something a bit more serious. I don’t know. Maybe like. Maybe Jordan Peterson, he’s pretty. Oh, wow. He’s got some good, some good stuff to say every now and again.

[01:22:59] Yeah. Like you said, Michel. Brilliant minds. It’s been wonderful having you. Yeah. Thank you so much for doing it. I’ve really enjoyed that. And you know, I’m sure

[01:23:10] We’ll see each

[01:23:11] Other if we can get you out of Cornwall sometime. I’ll be there. I’ll be there. Sure. Sure. All right. Thank you so much for doing this. Thank you.

[01:23:21] Thanks for having me. Thank you.

[01:23:24] This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry.

[01:23:35] Your hosts Payman Langroudi and Prav Solanki.

[01:23:40] 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.

[01:23:54] 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

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