In the business of buying and selling practices, this week’s guest is the dental leader.

Back in 2000, Andy Acton co-acquired Frank Taylor & Associates (FTA), which he went on to grow into the UK’s leading name in dental practice acquisition, valuation, development and sales.

Andy takes us through the business’ early years, explains how COVID has effected the market and dispenses an encyclopedia’s-worth of wisdom on purchasing and growing practices.

Enjoy!

“The craziest situation I’ve ever had…is somebody bought a practice and – I kid you not – he went and changed his name by deed poll to the name of the person he bought the practice from.” – Andy Acton    

 

In This Episode

00.55 – Buying the business
08.32 – The competition
14.11 – Selling for free
17.10 – Deregulation
20.45 – Signs and scenarios
27.42 – Deferred income
33.06 – COVID and acquisitions
40.43 – Then, now, growth
48.31 – Darkest day in business
52.16 – Squats, small practices ambition
01.02.14 – Super associates
01.04.23 – Owning a practice
01.06.03 – Last day on earth

About Andy Acton

Entrepreneur Andy Acton is a director of the FTA group of companies providing business services for dentistry.

The group now incorporates FTA Finance, FTA Wealth and Management, FTA Law, FTA recruitment and FTA media.

Andy is also a popular public speaker on leadership, management and practice development.

Andy: I see so many people doing things that they don’t enjoy, and it’s heartbreaking. I would say, above all, enjoy yourself.

Intro Voice: 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.

Payman: It’s my great pleasure to welcome Andy Acton on the podcast. I mean, we call it the Dental Leader’s podcast. That doesn’t mean everyone has to be a dentist. Andy’s actually dominating, if that’s the right word, the practise sales side as Head of Frank Taylor & Associates. Andy, thanks for coming on the show. Lovely to have you.

Andy: Thanks for having me.

Payman: It’s a pleasure. Tell us how you got into this, buddy. I mean, when you think of practise sales, you think of Frank Taylor completely. I mean, I envy your sort of brand position. Was Frank Taylor the first or how did this happen?

Andy: Yeah. He was the first, yeah. So what happened was back in the 1980s, there was a Frank Taylor and his business partner Sandra Rhodes. And they worked for Claudius Ash, who you’ll probably both be familiar with, the dental supply company. So they were going out and they were visiting practises. And as a result of visiting a number of different practises, a question started to come up, which is, “So what’s my practise like compared to the one down the road?” So Frank would say, “Well, it’s better than the one down the road, but it’s not as good as the one in the next town.” And then he goes to another practise, and the same question will come up time and time again. And sure he didn’t realise actually what people were asking was really, where did their practise rank in terms of value?

Andy: So Frank and Sandra went back into Claudius Ash and said, “Look, we’ve got an idea. We think there’s an opportunity to value dental practises.” So Claudius Ash being quite progressive said, “Well, that’s a good idea. Do you want to try that?” So they gave it the name, which in hindsight, probably wasn’t a great one. They called it Confidential Services, which has different connotations. But I kind of understand why, because what they were doing and what we do now is very confidential. So they trotted out and they started evaluating dental practises. And that was the very first time it had ever become an independent market in its own right. Because prior to that, dental practise has changed hands by basically people going down to the pub, or sitting in a cafe and talking to somebody and they sold to someone they know. But now suddenly, there was an independent market.

Andy: And then 1988 came along, and Claudius Ash did a strategic review, didn’t feel that Confidential Services fitted with the core strategic direction. So Frank and Sandra said, “Well, do you mind if we take this out on our own in this venture?” They said, “Well, go with our blessing. And good luck to you.” That was the start of Frank & Taylor Associates back in 1988. And they valued the sole dental practise, that’s what they did. They continued to do that through to 2000, and I bought the business back in 2000 with my still co-director and shareholder Christopher Evans, because we were working together in the city. And we’ve been working together for… Well, I’ll come back to how long we’ve worked together for in a second. But we’ve been working together in Bank of Ireland, developing solutions for the professionals such as lawyers, dentists, doctors and other health care professionals.

Andy: I joined this bank, the back end of 1999, just before we clicked over to the 2000s. So this was November, 1999. By March 2000, Chris and I decided to buy a business together, which, when I advise people now on entering partnerships, or buying a business together, the thought of knowing somebody, because I didn’t know Chris at all, before this period, to buy a business and get involved after four months seems crazy. It’s slightly distorted, because we worked intensely on a project. So we were working 16, 18 hours a day together. And through that process, what we found is we got on really well with a classic Venn diagram, I cut out some stuff, he cuts out the other. And we got on really well. So initially, we approached the bank to buy the business because we thought it would be a really good idea for the bank, because then they could provide the finance for the acquisition of dental practise. And the bank said, “We don’t want to do that because it’s too niche.” And we were like, that’s the point. The point of doing it is to capture a market. But they didn’t want to do it.

Andy: Quite incredibly, the bank gave us their blessing to buy the business ourselves, which was great. So we were two guys, we were working in the city, had good jobs in the city, we now owned a business on the side, which in our mind was going to pay us a great big dividend. And we were on cloud nine. Then in month three or four of business ownership, we realised that we had no money and we couldn’t pay salaries. Because what had happened is the people we bought the business from, Frank and Sandra, they weren’t involved anymore, so they didn’t care about the business. Sure they were doing a good job, but they weren’t responsible for running the business. And that was like a business Lesson One, is that when you own the business, you’re the person in charge, and the buck stops with you. So we had to change our attitude and mindset very, very quickly.

Payman: Andy, quick question there. Was the business on the market for sale at that point? Or did you approach them and say, “This is the ideal business we want to buy.”

Andy: It wasn’t on the market. We approached them and said, “Would there be an opportunity…” We knew they were of an age where selling was probably going to be on their horizon at some point. And then I think what starts happening is, even if it’s not on the market, when you start conversations, the art of the possible and the what ifs started gaining traction. So when that conversation started, both Frank and Sandra thought, “Well, we could sell and we could work on as consultants, and this could be a pathway to retirement.” And suddenly it started to snowball. But no, it wasn’t openly available as a business, which in many ways was good for us, because it meant that we could have lots of private conversations without there being a competitive situation.

Payman: How were the earlier years? Were you struggling?

Andy: It was hard. And the reason it was hard is that we didn’t commit. We kind of dabbled and we kind of had it on the side. So we bought the business in 2000, and we did this probably for a couple of years. It was 2001, 2000. So both Chris and I were full time in the business by 2003. Chris did an amazing thing, he actually moved over part time. He left the city, he worked the business part time, we both committed to make sure that it worked. But when we joined full time in 2003, that’s when it started to motor, that’s when we really were able to capitalise on the opportunities, but also build out the strategy. Because remember, this was a business that valued and sold dental practises like it does today. And that’s what it’s well known for, and what I believe is it does really well. But from a business point of view, there’s a massive risk, because if that sector of dentistry catches a cold, we’re out of business.

Andy: So early on, we worked out, that we need to start bolting things into this business to make ourselves safer in terms of our livelihoods. But also there were real added value services that dentists needed that weren’t being serviced out there, for example, arranging finance. Back in 2003, dentists just went to their local bank manager and hoped they got the result. So we introduced a brokerage and we helped them from that side of things. But it was difficult. And I guess one of the things that people tend not to see, they only see that whole social media and they see stuff on social media and everything looks so easy and straightforward. But in the early years, it’s hard.

Andy: When we first bought the business, I wasn’t actively involved in a day to day basis, so I worked in the city full time. So I’d start early, I’d get into the city by 7:00 in the morning, and I’d leave at 3:00 in the afternoon, I then head over. The office was then in Potters Bar, I’d get to the office by 4:00 o’clock in the afternoon, Chris and I would then work together till 9:00, 10:00 in the evening, and I’d repeat that. I did that for the first 18 months, two years of owning and running a business. New guys would have done the same and thousands of other people have done the same, but that never really gets talked about, because all people really want is, “What’s the quick fix? How do I go to from zero to a million in 24 hours?” And the reality is, it does exist, but it’s exceptionally unusual for it to happen. And actually, it’s the years of graft and hard work that gets you to a position when you’re in the market.

Payman: Absolutely. So then, at what point did these other competitors come along? Were there competitors in the early days?

Andy: In the early days, there weren’t really. There was an organisation called [Hemi Pirlo 00:08:46] Group. They started at a similar time and they were doing a thing like us. They were based in the south as well. So in reality, we had a clear run for an awful long while. And then a major change that happened, because back then the value of dental practises was relatively low. It was somewhere between 25 and 40 or 50% of turnover. It’s changed in terms of how value practises are valued. But that was kind of a rule of thumb. But then what happened was around about late 2005, 2006, when what was called the new NHS Contract came in, there was a massive shift, because effectively if you have an NHS Contract, your income is capped. Associates felt vulnerable, so we had hundreds of associates coming to us on a regular basis wanting to buy a practise. As a result of that, value shot up.

Andy: My business works on a commission basis, so we get paid on completion of the deal. We get paid by the person selling the business. So as values went up, when you earn a commission on your increased value, it became more lucrative and more attractive, and I think it was probably that [inaudible] brought other people into the market. As we are today, there’s probably about a dozen companies that do what we do across the UK to varying degrees of standards and success. Some of them fell out of recruitment businesses that said, “Well, we do recruitment.” So that’s matching people to jobs. So matching people to buy as a practises kind of things. Some specialise in it, absolutely. Others were just valuation companies that perhaps provide evaluation services to banks, and then branched out into doing the brokerage side. So there’s a mixture. I think the difference is that Frank Taylor & Associates set out to do this. This was kind of a plan of what they wanted to do, so it was a slightly different start point.

Payman: Andy, when you had no competition, and then fast forward in today, where there’s, let’s say, a dozen or so people in the market, maybe fighting for these people who want to sell their practises or people who want to buy. Do you feel back then maybe you were a little bit lazy and complacent, and then competition makes you kind of like up your game? If you look back then, looking at where you are now, are there any differences? Would you have done anything different?

Andy: I don’t think we did anything different. We were lucky back then, because we were a couple of guys who didn’t really know what we were doing. We were winging it. And because there wasn’t competition, it definitely did give us a breathing space to hone our skills, learn what we’re about, and gain our 10,000 hours. So we were able to do it at a time when competition wasn’t advanced. The reality of where we are now, I love competition, because without it, it absolutely does make you lazy, it makes you complacent. And there’s nothing worse than a situation where you have to use somebody, because there is no competition. And you know that is dire, you know it’s awful, but you just have to do it. You know how many monopolies are out there where you just think, “Well, I’ve no choice.”

Andy: If you want to get on a train, okay, I know some is privatised that kind of the rolling stock on the line today, there isn’t really much choice, you just have to accept mediocre service. So for me, competition means that we constantly have to stay on our game and make sure that we’re always improving and staying better because some of these champion our heels. And for me, it’s great because my view is legacy doesn’t mean a thing. It doesn’t mean… N really cares where you’ve been around for six months or 20 years. It’s what are you doing now? What are you doing today? And what are you going to be doing tomorrow? And that’s where, for me, it’s about consistency of what we do, always about we have to be consistently excellent. But also, if the marginal gains, I think competition makes you think about those 1% improvements, because you can’t [inaudible 00:12:33]. For me, I love competition. I love it.

Payman: If I was looking at selling my practise, is the massive unknown playing field out there haven’t got… Let’s assume I don’t know how a practise is valued, I just know I’ve got to that point in my life I want to sell my practise. There’s 12 people to choose from. How on earth do I go about making that choice of who to go to, to trust with my business to get me the maximum value? Or actually, irrespective of who I choose, is my business going to be valued on a multiple of my adjusted profits? And that multiple give or take a little bit, I’m going to end up with the same end result. And imagine, I know nothing about this, let’s say, so educate us.

Andy: The reality is that most people in your situation, most people will only go through this process once. And that’s dangerous. If you think about the first time you do anything, and you don’t know what you’re doing, you feel really vulnerable, you feel quite exposed. It’s where do you go for reliable information. For us, fortunately, because we’ve been doing this a long time, there’s a bunch of people out there that have worked with us and been through the process, and it’s gone well. So speaking to friends and other people within the profession, to get a guide on kind of who the good guys are, is a really good start point. But in terms of the approach we take, we are unique in how we go about our business, because one of the things that we do is I charge the seller for their service. So I’m going to engage with you as the practise owner, we’re going to have a letter of engagement, I’m going to act for you. But differently to the other people that operate in this market, I’m going to charge you for my service.

Andy: There’s a lot of talk in the market that you can sell your dental practise for free. As soon as you say the word free, people love it. So if you go to a train station, and there’s somebody handing out breakfast bars, there will be a queue of 50 people waiting for breakfast bar because it’s free. They might not even want the breakfast bar, but because they’re going to get something for free, they love the idea of it. So you then translate that into so your dental practise for free is highly attractive. The danger with selling dentist practise for free is you’re not the person that is paying for the service and there’s only other one person in that transaction and that’s the buyer, so the buyer is going to be paying the broker to sell the practise. So where the buyer is paying the broker who’s acting for you, it makes no sense. It’s illogical, because there’s a conflict of interest. And normally in my world, if I’m paying for service, I expect that service for me.

Andy: So as a seller of a dental practise, you really don’t want to move into an environment where you sell for free, because actually, it’s the buyer that’s paying for it. And I recently watched that programme, Social Dilemma, and in Social Dilemma you say, “If you’re not paying for the product, you are the product.”

Payman: Very true.

Andy: And if you’re selling your dental practise for free, then someone’s making money off you, and that’s not right. So going back to the value side of things. In essence, it’s a multiple of adjusted net profit. But also it needs to be considered in the context of so many things; the location, how the fees are generated, who generates the fees? Is it freehold or leasehold? What sort of dentists has been delivered? What are the core costs? I know that staff costs should be about 20% of turnover. Are they at 20%? Are they higher or are they lower? Who delivers a dentist within the practise? Typically, a principal would produce a gross of somewhere between 250 and 300,000 pounds, which is quite reasonable. If your principal is producing five or 600,000 pounds, then there might need to be adjustment, because that might not be something that could be achieved by the incoming principal. So you might have to add in some additional social costs.

Andy: So what you need to do, is you need to rebuild a practise based on what it would look like for somebody else buying that practise. But also, the multiple applied is important in the context of what’s that being applied to. So if you’re working to an EBITDA number of say 500,000 pounds without kind of getting too technical about it, and you had a multiple of five times, that would be two and a half million pounds. But if you had a smaller EBITDA with a higher multiple, you could end up with a higher number. So because you’ve got lots of different numbers and elements in this formula, it’s really important to work with a broker that is able to explain to you how they got to their value.

Andy: The other thing that’s important is if you’re a practise owner and you’re looking to sell, you got to be sure that the broker you’re working with can actually get that price, because there’s no point in giving you a flat in new value, if what you’re actually looking to do is so.

Payman: Andy, when you were growing your business, it was about the same time that the corporate started deregulating first. Do you remember the time when it was only like eight companies allowed in it. Suddenly, there was that deregulation, that massive influx of cash from the corporates. What does that mean to you day to day? I mean, what do they do? Do they work with the likes of you or do they have their own full on people trying to find practises for them? How does it work?

Andy: Some. They don’t like guys like me, because my job is to… We never fall out with them. I don’t think I’ve ever fallen out with anybody, but what they don’t like is my job is to get the best price I can for the seller. Their job as a buyer is to get the practise for as cheap as possible. We just stay opposite ends of the spectrum, and that’s just business and how it is. So what they tend to do, is they tend to approach people directly. They’ve got a good sales network, and they talk through their model and how they work. The bit from a seller’s point of view that you need to be careful with, is the corporate approaches you and invariably what the corporate will do is the corporate will value the business for you, and they want to proceed and buy that business.

Andy: The issue I have is, if you, say you’re sitting in your home, you own your home, somebody knocks on your door and says, “I’d like to buy your house. What I’m going to do, is I’m going to tell you what your house is worth, and then I’m going to buy your house. Is that a good idea?” It probably isn’t. And don’t get me wrong, I’m not saying don’t sell to a corporate. A corporate is a good exit route for somebody. What I’m saying though, is you should really get it valued by somebody else as well, to make sure that the value of the corporate you’re suggesting is a reasonable and fair value.

Payman: I guess it’s like going into court and saying, “I’ll just use the opposition’s lawyer for some advice.” Right?

Andy: Exactly. Not the best idea today.

Prav: No.

Payman: They have sort of inflated prices or in the past anyway, so I guess that influx of cash has helped your business a lot, right?

Andy: It has, yeah. I mean, what’s happened over the years is there’s lots of small and large corporates. So we’ve got smaller corporates. And at the bottom end, if you’ve got eight or 10 practises, I’d say you a micro corporate. And we go all the way through to the end of my dentist and [inaudible 00:19:25]. And you guys are coming on in leaps and leaps and bounds at the moment. But what you’ve got is you’ve got the corporate market is very much designed around. They acquire lots of practises for a multiple, make it bigger and sell it for a bigger multiple. That kind of the logic that goes with it. That’s great if market conditions are such that when you decided to get out, there’s appetite to sell at that high multiple. If there isn’t, and at the moment, we’re seeing an awful lot of small and midsize corporates with practises that aren’t necessarily making money on an individual basis, because they were hoping and expecting to get at a mega multiple.

Andy: I always say that if you’re going to grow a group of practises, make sure that each of those practises on a standalone basis makes money in its own right. Because if they do, you can hold them away for the market conditions to improve. If they don’t, then you could be in a sticky position. I think that one of the things that corporates generally don’t do is reevaluate their portfolio often enough, they don’t they don’t churn it. It’s that classic. Look at the bottom 20% and see what’s not working. Because lots of practises just don’t work in a corporate model. They lend themselves to be owned and run by somebody in the practise on the ground there on a day to day basis, produces a gross, and motivating and inspiring their team.

Payman: Let’s go through that, then. Let’s say I own one practise, and I’m seeing all this activity, and I think I’m going to buy a second practise, which is going to be associate led. What are the key performance indicators that I’ve got to look for? What would you say is healthy, and what can I expect from a practise that turns over revenue to half a million pounds? What should I be looking for as far as what’s a healthy practise to buy and how much can I get out of that practise, from a percentage perspective?

Andy: If you already own a practise, the start point will be to work out whether you want to stay working in that one practise, and leave the other one completely associate run, or whether you’re going to split your time between the two.

Payman: Let’s say for the sake of the argument, does everything leave the other one completely associate run.

Andy: So it’s going to be a completely associate run. So it will then come down to the profit would probably show on the accounts, somewhere between 22 and 25%, which is quite typical for general dental practise on an adjusted basis, EBITDA or reconstituted net profit. It’ll probably go to something like 35, 40%. But because you’re not going to be working there, you are going to be solely reliant on associates working that practise. So the 22 to 25% fee isn’t going to work, because you’re going to need to increase your associate fees. So you’re going to probably come down to somewhere between 10 and 12%, as a net profit by not working that practise. The challenge that it brings is, and this is where the corporates tend to favour the three, four, five associate practises is that you really need to be a certain size, because you need somebody in that practise, so in managing money, you ideally need a practise manager.

Andy: And when I say practise manager, I mean a business manager. I mean, somebody who’s going to be a meanie you who is in there, actually kind of grinding the cogs and make sure that things happen. Because if you’re the owner of your practise, but you’ll never have this practise in your line of Associates, the reason that people are working in a business is because they’re happy having that life and being in that sort of environment. If they were business owners, they wouldn’t be working with you, then they’d left, and they’re gone set up their own thing. So on a day to day basis, they’re happy working, so things slip. So your materials. Your materials, perhaps should be at six or 7%. If you’re on the ground, managing and keeping an eye on it, they turn into 10 to 12%. And that trickles through the business, you get out of these inefficiencies.

Andy: So in a smaller practise, you either have to split your time between the two, or what you have to do is bring in a business manager. The problem that that brings is the business manager is probably somewhere between 40 and 50,000 pounds, because this isn’t a practise manager or glorified practise manager who’s just going to get in there, make sure that things happen. And that is the challenge, because quite often there isn’t the profit in the business to pay that person. And that’s when you go back to the earlier comment, which is where you get principal splitting cells between two practises, because the numbers don’t quite work.

Payman: Andy, on the flip side, I mean, I work with a lot of dentists who were at various different stages in their personal life or business journey. So you get the one who’s got towards the end of their career and they just want to throw the keys in and walk away. You get the ones who think, “I’ve got another eight to 10 years left in me. I’m happy to hang around for five of those tied in.” And you see all of these deals coming in whereby what you get this value where you’re tied in for so long, and you’re on this rate, et cetera, et cetera. Can you just sort of describe the different scenarios that people find themselves in. I guess the right deal is only the right deal if it’s the right deal for you in terms of your lifestyle and how long you want to hang around for versus handing the keys and then whatnot, and where did your experience come in advising people?

Andy: 100%. And that thing about the right deal is the right deal based on your situation. I got this thing that I think that practise ownership, I think people start to suffer fatigue around about the 10 to 12 year mark. The amount of people I see who were associates only run a business and to start with they love it. They go through a period of growth, things flatten out. They flatten out and then about five years later around the 10 to 12 year mark on down, and sadly, so many of them still really enjoy their clinical dentistry. It’s just the grief and the hassle that goes with [inaudible 00:25:11], the favour of the duty. And quiet for many people it never manifests into anything, but just that kind of the Sword of Damocles hanging over them. And the exit depends on what you want.

Andy: If you exit and you sell to an independent dentist, that will typically look like possibly a three-month handover period, but it is the classic case of [inaudible 00:25:35]. You collect all your money on completion and you don’t go back to the practise. A slide on that same scale might be you sell, particularly if it was a private practise, because you might want to do a handout to make sure that those patients were integrated to the new principle. You might have a hand over a period of three to six months, you’ll be retained on an associate basis, so you would still receive all of your money on completion for sale price that would come across your completion. When you start moving into the corporate model, what they tend to do is they tend to agree a price with you. And then they would typically pay 70% of that sale price upfront. Sometimes it’s 60%, but typically 70%. And the 30% deferred is paid to you over an agreed period of time. And typically, that’s somewhere between three and five years.

Andy: So you continue to work with the corporate as an associate being paid, and that pay rate would be down to negotiation, but it could be anywhere between 35 and 45% as an associate. You will then be paid your associate rate for delivering your dentistry for three to five year period. So long as certain KPIs, key performance indicators, will match year on year, you would then get your deferred element paid out over that three to five-year period. If those KPIs aren’t met, there is a risk that you don’t get the deferred element. So going back to that, what’s the right deal for somebody? If you want the sale and get out, send it to an independent dentistry, is the more attractive route because you get all your money and you get to go.

Andy: If what you’re saying is, “Well, I want to get my money out, I want to stay on, and I want to work in an environment where I still want something to add on, and I don’t mind leaving some money in the business and being paid out over a period of time,” then the corporate model works. So it’s really about understanding what people want to achieve, and then matching the buyer to suit the seller. In my experience, the majority of people want to sell, get their money, and go. And I think that’s because so many people start the process of thinking about selling probably about two to three years before they talk to me.

Payman: Andy, just going back to that deferred income argument. I’ve had numerous conversations with people, and the advice I’ve heard sort of thrown around is that if you’re happy with what’s being offered on day one, i.e, your 70%. Just consider that’s what you’re getting. And your 30% if you get it, is a bonus. And then, how can you expect your business to meet the KPIs that they’re setting for you that are based on when you own the business and you control the marketing budget, blah, blah, blah, all these different variables in your business, and all of a sudden they come along, change the pricing structure, change the marketing strategy, and the KPIs are on that. So there’s numerous conversations I’ve had. Do they ever intend on paying that 30%? Is there an engineering of, “Hey, we’re getting in this practise for 70%, and we’re never going to pay that because we can change the game”?

Payman: Just playing devil’s advocate there. And obviously, you’ve got more experience about seeing these deals come through. How often do you see the full deferred value being paid versus not being paid? I know for some of my friends, I’ve seen it not happen several times. But I’d like to hear what your thoughts are on this.

Andy: Yeah, I think if we go pre COVID, the payments were… different corporates work in different ways. Some corporates put in incredibly stringent and stretching targets. And then they do play around with the costs. They don’t make it impossible, but they make it incredibly difficult to hit those triggers. And bearing in mind, you could be looking at a two million pound practise. So 30% of two million quid, that sits on 1000 pounds. That’s quite a differed chunk. Therefore, from a commercial point of view, if that 600,000 pounds didn’t have to be paid across, you can see why that might be of interest. Having said that, to be fair to the corporates, I don’t think that they genuinely set out to not pay this amount of money. I think they do intend to pay that money. I think sometimes the deals aren’t structured in a way to help achieve that being delivered. From where we are now, unfortunately, there are lots of deferred payments aren’t being paid.

Andy: In reality, what you said is right. If the upfront payment is good enough, then that deal should work for you. If you get the deferred over a period of time, then that’s good news, and is a bonus. I think for many people, practise values have been high for quite a while now. So if we roll back to the mid 2000s, when values were shooting up quite high, lots of people were really surprised at the value of their dental practise because they were used to them being woefully undervalued. Whereas now, lots of people have a pretty good idea what it’s worth. So when you take 30% of that figure, for lots of people, the 70% isn’t quite enough. That deferred argument, they do need that deferred anyway, and they expect to see it come through. And the challenge for lots of people setting is the reason that lots of people who say, if they don’t want the grief, perhaps, so the management, the people issues, everything that goes with it.

Andy: But if you’ve got 30% of your value still retained in that business, you can’t really just completely walk around being associate, you’ve got to continue doing those things, because you want to get your 30% sale. So for many, the corporate world doesn’t quite meet all of their objectives, because they continue having to be actively involved in the business, because they’re protecting this 30% that’s deferred.

Payman: Part of your value add, do you help in the negotiation of what those terms are, about how those retention figures are met, or what the structure is, in terms of their guidelines, or is corporate is pretty strict that this is what it is, walk away? Is there some movement in that when you’re speaking to them?

Andy: Yeah, we do. We negotiate on their behalf. And I think the start point and where people negotiate with corporates directly, they’re incredibly good at just setting out an offer. And that’s their offer because for many of them, they’ve done this time and time before. The buyer side of sellers often assume that there isn’t any negotiation, but there’s always negotiation, there’s negotiation on everything. My wife finds it renders the embarrassing whenever we go anywhere, on negotiating all over the place. I love it for fun, but it you should be negotiating. You should be improving the percentage that you’re being paid as an associate, you should be shopping the differed terms, you should be trying to reduce the amount that’s deferred, but critically thought about those KPIs as well. Because at the moment, it’s challenging times. And if they put in some growth measures that are coming over the next two or three years, we don’t quite know what’s coming down the line. And it’s small things like if you miss your target in the first year, can that be rolled over into year two?

Andy: So let’s just, for ease of numbers, let’s say there’s 300,000 pound deferred, and it’s 100,000 pound in year one, same in year two, same in year three. So if year one’s mixed, does that mean you lose it, or could it be rolled into year two? For me, that’s the sort of thing that should be negotiated. Because if you fall short in year one, but you’re on target to have a cracking year two, that actually that should be paid in year two. But if that wasn’t part of the agreement, then potentially you missed out on that first portion. So yeah, but for my part, everything’s up for negotiation, or it should be.

Payman: Andy, what’s COVID done to practise acquisitions’ prices the way people are thinking, the psychology. Because from where I’m looking, a lot of associates now are getting a much tougher deal than they had before. And the ones who are able to are looking to buy practises. Is that right?

Andy: Yeah, absolutely. Normally, when big change happens, we see a flock of associates coming to us to get on to practise ownership. And I think what happened is through COVID, associates mostly earned over 50,000 pounds a year, there was no government support, but basically what it meant, you start dipping into your savings. Life being what it is, we all know that we should always have three months to clear savings to cover our outgoings as a slush fund. That kind of works for lots of people. Some people didn’t have that slush fund set aside. But when dental practise is shut three months, they burned through that quite quickly. Then when we got the end of COVID, and practise started to reopen, a few things happened. One, principles didn’t take associates back as quickly as they were hoping to because they were starting to deliver that dentistry in themselves. And when you factor that at the time, everything else it was difficult for them to work at the pace they were pre COVID.

Andy: Lots of practise also ran back to the associates and said, “Look, times are really hard. And I know I used to you used to be paid 45%, but I’m really sorry that now and these look more like 35%. 30%. 25%.” So their pay rates got reduced. And they also felt battered and beaten up because they were vulnerable. And so now you’re absolutely right, Payman. The amount of people that are coming to us associates that say, “I can never put myself and my family in this situation again. I need to buy a practise.” And don’t get me wrong. Owning a business as you guys know, hasn’t been easy through the pandemic. It wasn’t kind of a licence to print money. It wasn’t easy. But we had assets to go back to. We had an asset and a business to return to, so we can keep going, where’s an associate, you’re vulnerable.

Andy: So the amount of socialists that have come to us who are wanting to buy a practise has has really spiked. But what’s also happened is the values of dental practise have held up really well, because the true value’s point of view, what I need to do is I affected you need to remove the lockdown period, because you have to, because we all know the reason why they weren’t able to deliver dentistry. Since practise reopened, the ones they could have opened from the 8th of June, in reality, most were back on their feet sometime in July. But when you look at their August, September and October numbers, they brought it back to pre COVID levels, which, obviously from a professional point of view deserves a massive pat on the back, because they’ve had to factor in increased PPA, fallow time, some people work in between two surges.

Andy: So to get their numbers back to where they were pre COVID is nothing short of remarkable. But what it does mean is there’s values of held up really well. But importantly, that’s also been supported and backed up by the banks, because the banks independently have practises valued before they lend money. And the bank valuations are saying the same thing as we are. So it’s not just me as a broker kind of trying to talk the market up and say, “Oh, no, everything’s fine.” [crosstalk]

Payman: Andy, you must know. I mean, I certainly came across some distressed practises and some extraordinary deals for practises over that COVID period. Whether it was guys who just did not want to look at the whole PPE nightmare, or people who ran out of money, that happened, didn’t it? Some people got practises really cheap.

Andy: There were some practises that people picked up cheaply. I think it’s easy to look at COVID and say that was the reason. I think when you look at lots of those practises, they were in unknown distress pre COVID. This three-month period was the thing that tipped over the edge. These were practises that weren’t being well run. And it was the COVID thing-

Payman: Is that Warren Buffett thing about when the tide goes out, you see who’s swimming naked?

Andy: Who is swimming naked, is actually right. There are lots of people who didn’t have their causes on for sure.

Payman: All right, so tell us about, over the years that you’ve been doing this, you must have seen some wonderful stories, right? You must have seen some people who’ve really… we’ve had them on the show, people who started with 50 grand and opened 20 practises or whatever it is. And you must have seen the opposite side of it as well. In fact, within the same deal, I’m sure some practise [crosstalk 00:37:41]. Tell us about the horror stories. I mean, what should people more people know about practise sale and practise, purchase, and consider that they don’t?

Andy: I think on the purchase side of things, I think the thing where people seem to get it wrong time and time again, is the biggest change a business can go through is a change of ownership. So bearing in mind, a person that’s selling has probably owned that business for 10 or 12 years. So the team know them intimately. All the processes, the system, all those cogs. There is a well oiled machine, the patients know the consistency of visiting that location and what it looks like and feels like. So a change of ownership is massive. So anybody who buys a business who goes in and then start chucking their weight around by moving Rebecca off the front desk and bringing in Matthew, or repainting, or adding in another surgery or changing the branding, stop, stop it. Don’t do it. Do nothing for six months. Just move into the practise, and watch and listen. Just don’t do anything. Just be a dentist, and just get a feeling and understanding as to who does what and how it works.

Andy: Talk to your team, then start making changes, because you’re going to do it with your team on site. Patients are going to know you’re a good person, and you can meet them in a considered way. And I get why people do, [crosstalk]

Payman: Exciting.

Andy: It is. They spent a lot of money, it’s their practise, they want to make their mark, but honestly, it’s the worst thing you can do. There was a guy who bought a practises, sorry. And he went in and did exactly that. He changed everything. It was a small village. It was a really well established practise. The team didn’t like it, half of them left. The patients didn’t like. It was a private practise. There were other choices in town, the patient started to drift away, it was a disaster. If he’d have just done nothing for six months, I think the outcome would have been really different. Which it’s a shame, because he spent a lot of money on the practise.

Payman: So that’s a common thing. I hear that a lot of when people tell me they’re going to buy a practise. They come to us looking for photos and pictures for the new designs and all this. And I always tell them, “Look, evolution, not revolution.”

Andy: Absolutely.

Payman: Exactly what you said. The staff and the patients… in fact, it would be ideal if they had no idea.

Andy: The craziest situation I’ve ever had, and you’ve got to be careful, you don’t take this to an extreme. If somebody bought a practise, and I kid you not he went and changed his name by depot to the name of the person he bought the practise from.

Payman: What a-

Andy: Honestly. The thing is they were from different ethnic backgrounds, that when he turned up, and he said, “No, I’m Dr. so and so.” They’re like, “Well, no. Are you?” He says, “No, I am.” And he thought by changing name, it would be good. It’s like, why was it ever going to be a good idea. There are some incredibly strange things that go on.

Prav: Loss. Absolutely loss. Andy, when you started your business back in the day, you used to talk about doing those 18-hour shifts, call it the art of graph getting you 10 pounds, 1000 hours in and whatnot. How has that changed now? So talk me through the contrast between then and now. And so what is your role? And also the people in the organisation now who we used sort of steering?

Payman: Take us through the separate divisions as well, because I know you’ve got law, marketing and several others.

Andy: Yeah. So we had FTA, Frank Taylor & Associates, and basically, that was our one legged stool. And in 2009, we said, “Look, it makes sense to formalise the finance side of things.” So David Brewer was the leading range of healthcare financing dentist in the UK who’s with RBS. And one of the great things that fell out in the banking crisis is David wanted to change, he wanted to do something different. So he came and joined us, and we started FTA Finance, and FTA Finance now arranges about 160 million quid a year for dentists to buy dental practises across the UK, works with 14 banks. David’s a great guy, he’s the Managing Director of that business, and on a day to day basis, I don’t really need to be much involved in that business, he has it covered, which is fabulous.

Andy: Then in 2015, we actually bought a recruitment business, so we rebranded FTA Recruitment. Because we realise though, when you’re buying a practise, there’s going to be some churn, things are going to change. And associates, some are going to stay, some are going to go. Hygienists, some are going to stay, some are going to go. But actually, if you don’t have hygiene as part of your programme, your practise, you should, therefore you may need hygienists. So we’ve now got a recruitment business, and that primarily focused on delivering hygienists and associates in the practises. All the things we do add value, and are unnecessary business service to dental practises. If it doesn’t tick that box, we don’t do it. That was where the improvement came from. Then in 2015, we started through a licence agreement, FTA mortgages, so that’s residential mortgages and weren’t involved in that business at all.

Andy: We work with a team that help people through that residential mortgages. It is an important part of the mix, because quite often, where people are looking to buy dental practise, what they can do is take out the equity from their residential property. And that then becomes the cash contribution to buy dental practise. That was quite nice as a fit. In 2016, I set up FTA Law, and that was with Chris, my business partner from Frank Taylor & Associates. Also Lis Hughes, who’s the Managing Director of Frank Taylor & Associates, and Thomas Coates. Thomas Coates is a lawyer, been a dental specialist lawyer for a good number of years. He wanted to do his own thing, we thought he was a great fit. So we set up FTA Law, full service law firm in North of England, does transactional work, property litigation and employment and HR services, and the employees and HR bit through the pandemic has just blown up. It’s incredible how many people just don’t know how to manage conflict and furlough and job retention, and job support, but actually really valuable service.

Andy: Then in 2017, we set up FTA wealth. When you’re arranging finance, you obviously need insurance and protection. So you need life cover, probably some local insurance, perhaps critical illness as well. So we arranged that for dentists. But what we also do on the other side of things is when people sell their dental practise, surprisingly, quite often lots don’t quite know what to do with the lump sum. So we provide them with advice and suggestions and guidance on how they can invest that money to get a return. So that’s FTA Wealth. Then in 2018, we set up FTA Media, which is a video marketing agency. Honestly, I’m getting towards the end, Payman. Hang in there. Hang in there.

Prav: Very impressive, mate. Very impressive.

Andy: What we did, in 2018, we set up FTA Media, and that sort of fell out of nowhere. What we realised was that, from a marketing point of view, we were words and pictures. And what we weren’t doing is we hadn’t moved ourselves into the video marketing game. And I read that by 2020, 80% of our social media feed was going to be video based. And I thought, well, if we’re not there, we’re not going to get a thing. So we started out as an internal project and we turned the camera on Chris and myself, and we did some short videos and response was really good. And going back to that point about people like to know the people behind the business, it gave it a personality who could find out a bit more about us and who we are, and what motivates us, and what drives us.

Andy: As a result of that, we were approached by a pair of dentists who said, “I’ve seen you doing video, I think that we need to do video, could you help us?” So out of that fell FTA media. We’ve now got a full videography team and editing suite where we go into dental practises and we provide video for marketing purposes for websites. It’s patient journey staff, it’s patient testimonials, that side of things. And then in the last year, we’ve been working on a new project, which is FTA Academy, which is effectively trying to pull together all the materials that we’ve produced over the years for how to value practises, things you should do if you’re buying, things you should do if you’re selling and just sharing our content and insights so that dentists can find all that material in one place. So yeah, we’ve had we’ve had lots going on.

Payman: I like your style, one a year for a lot of years there, huh?

Prav: Yeah.

Andy: Yeah. We-

Payman: Maybe you get bored easily or something. And is that you who is always looking for this sort of growth?

Andy: Yeah, I think I’m quite impatient. But also, I think the thing that I seem to have a knack for is coming up with ideas and starting new businesses and getting them to a certain point. And then other people can kind of run it. But going back to your previous point about kind of what is he doing on a daily basis now? I spend most of my time strategically making sure that the groups are aligned, are they all looking and feeling like FTA type businesses? Are we maximising the opportunities for our clients benefit by introducing different elements of the group so that people get the best advice and best service possible? I’m also constantly looking for new things we can be doing to improve the services that we deliver, those 1% improvements all the time, and new ideas. That consumes my time and honestly, because when you multiply that up across six or seven businesses, I’m not doing 18 hours a day anymore, but it still keeps you busy.

Payman: Very nice, man.

Prav: And what does Andy do outside of running all of these businesses and keeping them all ticking and whatnot? What’s life outside of work for you?

Andy: So I try to keep myself fit. I think it’s a really important element. My daily life could be quite sedentary, it could be sitting in front of a computer or sitting on a phone call. So I like to keep active. As a kid, I played a lot of badminton to a reasonably competitive level. So I still play badminton occasionally. I enjoy that. I swim quite a bit. I’ll try and swim a few miles each week in the pool, which I really enjoy. I’m married, I’ve got four kids, I recently had a granddaughter turn up on the scene. So I’ve got this new job within the family as the elder statesman.

Payman: You don’t look old enough. Are you telling me you’re a grandfather, buddy?

Andy: I prefer the term grand dude, to be honest. I think grandfather’s not… I don’t want to be a grandfather. That makes it sound like some weird old, I would say. But it is lovely. So just with the kids, that consumes quite a bit of time. I enjoy going to sporting events when we can, it’s been an interesting year for that. So I’m consuming much of that through the television at the moment.

Payman: Andy, what was your darkest day in business?

Andy: Darkest day. Probably right back in the early days when we couldn’t pay those salaries. I think it was when we thought we knew it, or we thought it was all so straightforward. And we hit the buffers. I think that was the point, and we’ve all gotten there at different times, when you realise the importance of cash. Actually, nothing else in business matters if things aren’t producing cash. You can have the best ideas in the world, you can be the brightest strategic thinker, you can go and you can develop things. But if the thing you’re doing don’t produce money, at some point, you’re going to grind to a halt. Fortunately, for me, that happened really early. Because I think if it had happened quite late, the danger is if you just keep doing something, you don’t know how to do it differently. But because it so happened so early for me, I’m like, “Oh, okay, right. So we need to change what we’re doing. And we just adapt it.”

Andy: Yeah, that was a horrible moment. Horrible.

Payman: And going forward. How do you see practises valuing? I mean, I know it’s not in your interest to talk about a bubble bursting, but grand dude to dude. Dude to dude, take us through best case scenario, worst case scenarios, what might happen. Because people have been talking about bubbles bursting for a few years now.

Andy: Yeah, I think it’s simply economics. It’s willing buyer, willing seller, supply and demand. And at the moment, and it’s been the case for a long while, demand has outstripped supply for lots of practises by 2030:1. So until we get to a position where demand and supply can’t catch up with demand, because there aren’t enough dental practise in the UK. So I’ve got just about 5400 people wanting to buy a dental practise. And there’s about somewhere between 1000 and 1500 dental practises change hands every year. So we’ve got a 5:1 immediately. So until that, that kind of scales of justice starts to balance itself, that bubble won’t burst in terms of values. And I don’t see that situation changing because with five and a half thousand people, if we apply the 80/20 rule, I’ve got 1100 people, and I’ve got 1100 practises. So there’s one of everybody who wants to buy a practise at the moment.

Andy: And it’s genuinely not kind of me being a broker trying to talk to market. It’s just a simple numbers, there’s so many people wanting to buy a practise, and there isn’t enough practise out there. What has been interesting this year that has changed is, if we roll back a year, if you had a dental practise that was in a major city that had a football club, which I know is bizarre, if you think of cities that have football clubs, they always very popular for people to buy. And also towns where there’s a dental school, if you kind of go 50 miles away from dental school and draw a circle, they’re always popular, because lots of people kind of hang out in the area where they qualified. Those areas were always the hotbed to where people wanted to buy dental practises. But what’s happened this year, and we’ve seen it in our own behaviours, people tend not to be going to the city centre as much this year as they used to, and people are staying locally.

Andy: And what that’s starting to do is that’s starting to change people’s behaviours in terms of where they want to buy dental practises. And we’ve seen a real upsurge of people wanting to buy regional dental practises, which is quite interesting. So wherever it used to be major towns, major cities, the metropolitans always doing really well. We’ve seen lots of practise that might have been on the market for nine or 12 months, having renewed interest, because people are saying, “Do I really want to commute? Do I really want to go into the big city? Or it’s another way of doing it?” So there’s good things that come out of this as well.

Payman: Andy, do you do anything for someone who wants to start a squat?

Andy: We do. We help people. We don’t [crosstalk 00:52:24]. Yeah, we don’t have a specific service for them. I mean, through the pandemic, I’ve done a number of webinars and taught lots of people. And it’s increasingly people are asking about setting up squats. My own view is, I think there’s more people talking about it, they’re going to do it. Because I think a lot of people like the idea of it. And when they sit down and they talk to their mates about it, they get from zero to a successful practise over two or three points. You guys will talk to a lot of people that it doesn’t quite work like that. One of the things that I do as a start point is when I have a conversation with somebody who wants to set up a squat, I talk them through the important things about finding location, what services do you want to deliver? Where you want to be in the country? What sort of size space you want? What do you see looking like at a perfect practise in a few years time?

Andy: Just to make sure that they’ve actually done some thinking in terms of where it’s at. But what I’ll always do is I will always send a blank cash flow forecast, and then into a business plan structure. And I say, “Look, this is what you need. You need to lay your ideas down. Don’t worry about whether it’s finished or not, but lay them down in a business plan structure, and put some loose numbers based on how you work at the moment as an associate onto a cash flow forecast and come back to in two weeks.” I’ve had that conversation probably 30 times this year. And at the moment, nobody’s come back to me.

Payman: Yeah, but I don’t know. I think for me, the squat thing is probably feeling more seductive for more people. Firstly, because the value of practises is so high, firstly. But secondly, because the experiential side of patient journey has become a thing for having an experience that you can really design the way you want. I think a lot of these young guys will be thinking that existing practises isn’t what they want as the experience, they want something other, whether it’s we’ve got Robbie in Liverpool, that beautiful sort of boutique situation, or there’s lots. There’s lots of interesting experiences out there. But also post COVID, I was I was talking to Prav about this, I live just up from Fulham Road. And on Fulham Road, there’s something like 25 empty shops now, because of the shops that didn’t make it through COVID, I guess. And so for a dental practise where you have to be in bricks and mortar, in a way that’s an opportunity, isn’t it?

Payman: And so we bring all those things together. But existing practises are expensive, experiences are becoming the thing, and there’s this retail space now that was probably under priced, and you can have that dream come true positioning. I don’t know anything about, but I reckon there’s going to be more squats coming. Maybe you want to add like a Frank Taylor Architectural. [inaudible]

Andy: It might be at least something else to do. But I think you’re right. I think the difficulty and the challenge is, and it goes back to dental school, dentists are trained as technicians, which from a patient point of view is what I want. I don’t really care whether my dentist can read a [inaudible] or not, I want him or her to be a good dentist. That doesn’t translate well into setting up a squat, because setting up a new business from ground up isn’t easy. And that’s why most people want to buy an existing practise. I think if you have the ability or the wherewithal or the support to create a new practise, it’s brilliant news. Because one, what it does is it creates new dental practises. Two, it becomes your own vision, you can create exactly what you want, you have control over it, and you don’t pay for the goodwill. And from a sales point of view, what it does is it restocks the pond in terms of creating new dental practises, which in the future can be sold on.

Andy: I’m really supportive of people that want to set up small practises. But I’m disappointed by the amount of people that never quite get there. Because guys like Robbie, I mean, what Robbie’s done is incredible. But he’s an outlier. That’s not normal dental behaviour.

Payman: I meet a lot of younger dentists who want to be him now. And others, don’t get me wrong, but that experiential thing. I guess it started with DSD, with life changing videos and all that. And Prav, you must come across this?

Prav: All the time, mate.

Payman: People are saying, “Look, rather than give that money for goodwill, I’ll give that money to you for marketing. Because we’re going to-

Prav: I think the thing is here, is that there’s a lot of naivety around that. Okay, you’re paying for goodwill, but you’re buying into cash flow from day one, you’re hitting the ground running, you pulled some finance, okay, you pay a little bit over the odds. But you know the gross figures that are going to be coming in every month are going to be a certain amount. If you do your numbers correctly, you actually know you’ve got room to grow the business and okay, you don’t map out the Gucci experience from day one. But you’ve got money coming in. And if we go back to Robbie’s story, what was he doing day one? He was working in this practise that-

Payman: Yeah, you’re right, he bought an existing practise.

Prav: He bought an existing practise, and he was working in this practise that was nowhere near what his vision is. But he used that to maybe accumulate cash or whatever it was, and then build the thing. I guess it’s what’s right for that person, what risks they want to take. Many associates, they get themselves into a job where they’re working well, they’re making decent amount of money. And then it’s a case of forfeiting. I speak to associates who want to carry on doing three days at their current practise to pay the mortgage, and then launch a squat in two days a week. And it ain’t going to happen. It is not going to happen. I mean, only last week, I had a conversation with someone. And the conversation was, “Well, I support you turn it over at the moment, and it’s like, 10 grand a month.” That conversation he was having with me, I think he was-

Payman: Groceries.

Prav: Groceries, 10 grand a month, right? And I think he was expecting me to be impressed. But his idea of that is so pigeonholed because he’s isolated as a business owner, he doesn’t know how to compare that to other practises in the market. And I said to him, “Listen, mate, the best advice I can give you now is if you believe in your business, give Euro the job bob, borrow some money and throw it into that business, because 10 grand a month…” And I said, “Where do you want to get it to in 12 months time?” “I’d love to be at 13 grand a month.” I said, “Not ambitious enough for me.” Sometimes that is what we’re dealing with, is there’s a lot of naivety in the market. I’m not a practise seller, I’m a practise owner, right? But I can see the mistakes that people are doing and the vision that they’ve got, because it’s probably what we were thinking back in the day, or what we’ve seen.

Prav: I’m just going to say someone like Andy, who’s bought and sold more practises than anyone else in the UK, you can spot these mistakes a mile away, can’t you? And squats are suitable for certain individuals, and then buying an existing business. I don’t know about you, Andy. But I guess you’ve been buying existing businesses over the last four or five years. And so that may be your default advice is to say, “Look, we’ve got something that’s ready. We’ve got customers, we’ve got cash flow. It kind of makes sense to buy an existing business and then throw our sort of brand on top of it and do something better.”

Andy: Yeah, exactly. And I think as well, I don’t want people to lose sight that it’s okay to be an associate. Being a dentist is a phenomenal job. And I think over the past few years, there’s a danger that being a business owner or an entrepreneur is kind of the new rock star. And so there’s lots of people wanting to jump on the bandwagon, and own a business because it’s the cool, trendy thing to do. But it’s a cool and trendy thing to do for people to post on Instagram about it. But that’s not the day to day reality. And if you’re not set up and equipped for the hard grind, that goes with, let alone not even a squat, just owning a business. I think it’s that thing where it’s still phenomenal to be a dentist. And the impact they make on people’s lives is ridiculous. It really is life changing stuff. And if people feel pressure to move on to being a business owner, because that’s kind of the next rock star thing to be, I think people should back off.

Andy: If it was what they want to do and they’ve got a really good reason and a driver for why they want to do it, and absolutely buy a business to have a squat, that kind of don’t just get swept along with it because being a dentist isn’t good enough. Being a dentist is awesome. It’s an incredible career, and I think people kind of get swept up with this business side of things. I think for lots of people, it is okay to be a dentist, you just don’t have to buy a practise because you majored on practises.

Payman: A very good point.

Prav: And you know what, I think there’s a middle ground here guys, is that I’m seeing now associates coming to me. And this is brand new, right? That ordinarily, a client will typically come to me and say, “Look, help to grow our practise.” I’m having associates approach me said, “I’m an Associate at this place, but I want to carve out my own business inside that premises. So I want my own marketing strategy. I bought my own. I’ve invested 27 grand in a 3D scanner. About the practise, I bought it myself. Totally unheard of right? And I’ll take that wherever I go. I’m going to create my own patients. But guess what, I’ve not paid for business, I’ve not paid for goodwill, I’ve not paid for the building. But I’m allowing myself to create that. And for a practise owner, how amazing is that? Oh, I’ve got a chair available one day a week. You come in use it and fill the book as well. Happy Days.”

Prav: I think this is a new breed of super associate entering the market right now.

Payman: Andy, how does that come across in practise sales? I mean, if I’m owning a practise with a couple of these social media super associates on my associates, I’d expect that’s a more vulnerable situation because they can move anytime they want and take their patients away. Does this come into the conversation?

Andy: We’re not there yet, because it’s still quite a new phenomenon. But [inaudible] practise is spot on, you end up with these super associates. And because they inevitably operate in the private market, there’s patient choice and they follow the clinician. So from a practise owner’s point of view, it really comes down to what agreement you’ve got with that associate in terms of who owns those patients. Because if you have a practise of delivering a growth of a million pounds, but actually plus my super associate, and he’s knocking out 700,000 pounds of that. Realistically, can that be valued into the equation? Because there isn’t some locking that says that you’re going to be sticking around post completion for a period of time. Then the risk is the person buys it, they’re not actually buying a million pounds worth of fees, what they actually buy is 300,000 pounds because 700,000 pounds is going to be off, because you’re going to move down the road and you’ll be welcomed anywhere else.

Andy: So it is kind of an evolving model that’s happening below the scenes. And I think for practise owners, I think just to deny it and say, “Well, no, they’re my fees, it doesn’t work like that,” is probably naive. I think you need to work out an arrangement with those super associates that says, “Oh, look, actually, perhaps they don’t own those fees, and the associate owns those fees.” But the pay rate and the deal you have with them an ongoing basis, is you rent them space to deliver their business within your environment. Because ultimately, with patient choice, and with social media these days, I can tell patients where I am at a moment’s notice, and there’s a risk to a practise owner, that they decide to go somewhere else. But I think they need to work on a model to engage with these people, as opposed to just deny it and say, “Well, that doesn’t work for me.”

Payman: Andy, you’ve got quite a lot, probably more experience of running a practise than a lot of people from seeing all these stories. You’ve obviously got access to practises for sale. Have you never considered practise ownership yourself?

Andy: No, I think it’d be dangerous to. I think it’s a little bit like… Well, I think there’s a conflict, but also I think it’s a bit like somebody that spends a lot of time in the pub doing committees so you can run a pub. I’m an outsider, I see an awful lot in the business side of what makes a dental practise work and not work. That’s one of my skills. One of my skills is to value businesses based on how they’re performing and make suggestions to make it improve. Sure, I like to think my work well, we’ve kind of leading my team of people, but I don’t understand the mechanics of the clinical side, of the systems and processes needed to own your own dental practises. There have been cases in the past where people similar to me have gone into practise ownership, and it’s not worked out well for them. So I’m a firm believer too. I know what my core skills and strengths are, and that’s in providing business services to the dental profession. So until I run out of ideas in that area, I’ll stick to my field.

Payman: This isn’t going to happen soon.

Andy: Hopefully not.

Payman: Well, it’s been a real enlightening conversation. You do listen to this podcast? I know you do, Andy.

Andy: I do. Yeah, and I enjoy it very much.

Payman: Prav has a final question here. So I’m sure you’re aware of. Prev, go on.

Prav: Andy, imagine it’s your last day on the planet. You’ve got your kids around you. And you need to leave them with three pieces of advice. What would those three pieces of advice be? And then after that, how would you like to be remembered?

Andy: I think the advice for them would be enjoy yourself. I see so many people doing things that they don’t enjoy, and it’s heartbreaking. And I always say, above all, enjoy yourself. I’d also say, be kind to people. I don’t think you ever really know what people’s backstory is or what’s going on in their world. And it costs absolutely nothing to be kind to people. And lastly, be loyal. I think loyalty is something that in the modern world seems to be falling away at a rate of knots. So I think if they could enjoy themselves, be kind and loyal. I think they’ll have a really good life.

Prav: And how would you like to be remembered, mate?

Andy: I think similar. I think I’d like to be remembered as somebody who’s loyal. I think if somebody does something for me, I value it in the highest order. And I will always show ultimate loyalty to people. I think it’s really important that if people are doing the right thing by you, you do the right thing by them. And I think if more people as a community were loyal to one another, we all move forward together.

Payman: Thank you-

Prav: Thank you, Andy.

Payman: … so much for your insight into your world, Andy.

Andy: You’re really welcome. It’s a really good job, talking to you guys, it’s been good fun.

Prav: Been great.

Payman: [inaudible]

Andy: It has, hasn’t it?

Payman: Thank you so much, buddy. Hopefully see you soon, man.

Andy: Yeah, [inaudible]

Prav: Take care guys.

Payman: Take care.

Operator: 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.

Prav: Thanks for listening, guys. If you got this far, you must have listened to the whole thing. And just a huge thank you both for me and Pay, for actually sticking through and listening to what we had to say and what our guests had to say because I’m assuming you got some value out of it.

Payman: 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.

Prav: And don’t forget our six star rating.

Reader’s around orthodontics will be familiar with this week’s guest and author of one of the best blogs around.

Kevin O’Brien’s Orthodontic Blog is an exploration of orthodontic issues and debunking of some of the bad science, 

These subjects are just a small part of today’s discussion. The professor emeritus in orthodontics and former dean of the University of Manchester talks us through his student days in the city. We also chat about the limitations of orthodontic training, the state of play in the UK Vs the rest of the world, and much more.

Enjoy! 

 

When you look at trials of surgery, for example, it is not necessarily always the technique that comes up with the best results. It’s the skill and the care of the surgeon. And that’s the same with orthodontics. – Prof. Kevin O’Brien

 

In This Episode

01.36 – Backstory
08.05 – UK Vs the US
11.06 – Deanery, teaching and academia
21.29 – GDC
27.13 – GDPs and ortho
34.02 – Aligner science and new treatments
41.42 – On limitations
44.26 – The blog
55.02 – Ortho for cosmetics and health
01.00.35 – The future of orthodontics
01.05.19 – A quick plug
01.05.34 – Last day on earth

 

About Kevin O’Brien

Prof. Kevin O’Brien is a former Dean and current professor emeritus in orthodontics at Manchester University.

He is also a former chair of the General Dental Council and the author of Kevin O’Brien’s Orthodontic Blog – an ‘occasionally irregular’ exploration of evidence-based orthodontics.   

Kevin O Brien: Ross’s right, is what you don’t know is the problem. And when people think they know it all and that they go back to saying that they think they know it all and can do everything with Invisalign. For example, that’s where they run into problems. It’s not the appliances. It’s the operators and it’s the way they behave. And some of them, unfortunately don’t recognise their limitations. They’re working outside their scope of practise, and that’s where harm occurs.

Intro Voice: 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.

Payman: It gives me great pleasure to welcome professor Kevin O’Brien onto the podcast. Kevin’s got one of the worlds, correct me if I’m wrong, Kevin, the world’s biggest blog in orthodontics, but an illustrious career in academia. And for us, what we want to get out of this obviously is your backstory and so forth, but all those become such a controversial subject ever since it’s grown so massively with the GDP community in the UK. And so there were so many areas of it that need to be addressed. So welcome to the show, Kevin.

Kevin O Brien: Thanks so much for interviewing me on the second day of lockdown on a sunny day in Manchester.

Payman: Yeah. Nice to have you, Kevin give us your backstory. Where were you born? When did you decide to become a dentist? All of that stuff.

Kevin O Brien: Okay. So I was born in Edinburgh, so I am Scottish and then my mother moved to the Midlands in a small country village in North Westshire. where I was bought up. I then came to the university of Manchester in 1975. At that point, Manchester was not the city that it is now, there is a sort of in the depths of depression and I sort of suffered a major cultural shock coming from a small country village, slap bang into the centre of Manchester, which at that point was starting to become a much more multi-ethnic city. And I still remember going and having my first curry when I was 18. And that shows the isolated living that I had.

Payman: Did they have the Curry Mile back then?

Kevin O Brien: They did, but it was mostly sweet centres rather than curry houses.

Payman: On winslow road?

Kevin O Brien: Yeah, I think nine out of 10 of the restaurants were sweet centres.

Payman: Amazing.

Kevin O Brien: But again, that was quite a cultural shock for a boy coming from the country village where I’d look out the window and just see cows.

Payman: What was the first curry you had?

Kevin O Brien: It was terrible. It was a chicken biryani in a restaurant in Manchester called the Plaza, which was very famous among students because it was truly terrible. It would cost you 50P. Chicken was cold just thrown on top of the sort of watery sauce. And you only really went there late at night. A few of us, about five years after we qualified, went back and we realised what a terrible place it was. You wouldn’t recognise it as food nowadays.

Payman: What kind of a student were you Kevin? I mean, did you feel like these, the big city, bright lights, did you go a bit berserk on the social side or were you one of those?

Kevin O Brien: No, not really. Not really because I’m quite a quiet person anyway. And so now I think I was a pretty average student, when I was made Dean of the dental school in Manchester. One of the first things I did was go and look at the old student records, because they’re all kept in your office. So I looked back at the records for my year. These were the comments that were made on everybody. The only comment that was made for me was mostly average. That sums up my five years in dental school.

Prav: And so then you did some general practise. You were telling me.

Kevin O Brien: I had four sort of very happy years. I went into general practise straight from dental school. So there was no foundation training or vocational training in those days you went straight out and I worked just off the Langley estate in Middleton, which is an area of very high deprivation for a really nice guy called Allen Kershaw. It was a very simple, it’s a very basic practise and it really was great fun. I then moved to a practise in the centre of Chorlton in South Manchester and was there for another year and a half. They had to take me up to four years.

Kevin O Brien: But during that time I was sort of becoming more interested in sort of hospital dentistry in general. I was beginning to feel that general practise wasn’t quite a hundred percent for me. It wasn’t that I didn’t enjoy it. I just felt that it wasn’t for me in the long term. And then one night I was driving home on the, what is now the M 60 with my wife and six months old daughter and a guy hit us in the rear in the traffic jam, ripped our car off sort of flat in the back of the car and put me off work for six months with a whiplash injury. And then after I had announced that to one of my friend saying right, I’m off for six months, it’s going to be brilliant. He turned up and gave me a box full of books and said, right, it’s now time to start studying again for fellowship exams.

Kevin O Brien: This is your chance. And so I sat down for six months and studied for the fellowship in dental surgery, which put me an inroad back into hospitals. And I took it shortly after that. I took a job as a house officer at the dental school of the dental hospital in Manchester. And I did house office job there, did a job in Newcastle as ass hr and registrar in oral surgery. And then I was very fortunate enough to get on the post-graduate special training course in Manchester led by the absolutely brilliant Bill Shaw, who is professor of orthodontics at that point. And we were the first group of students to go through that musters programme, which was a classic. So two years master’s programme where Bill taught us to be critical and very analytical about research. And that’s where my sort of research interests really peaked.

Kevin O Brien: And it became a very vibrant place to be a postgraduate student. Following on from then. I again was very fortunate to get a medical research council research fellowship for three years to do my PhD. And I did that within three years and then just as I finished there, I was offered a post as a sabbatical at the university of Pittsburgh in the United States where I worked for a year, came back, made senior lecturer. And then about two years after that, they made me professor at Manchester. So that’s really my background.

Payman: When you were looking at orthodontics, what were you talking late seventies?

Kevin O Brien: I started orthodontic training in 1984.

Payman: Okay. Early eighties. So at that point, orthodontics was pretty established as a specialisation. But what would you say were the biggest differences between UK and US orthodontics back then.

Kevin O Brien: Yeah, at that point because of the way that dentists were paid to do orthodontic treatment. UK orthodontics was dominated by simple removable appliance treatment. I can’t actually remember the nuances of the payment system, but in many ways it was a sort of a very high volume delivery of care with what was shown to be very low standards. During that time, I worked with Steve Richmond who is recently retired as professor at Cardiff, and Steve was doing some real groundbreaking work on occlusal disease and quality of treatment. And Steve showed that during that time, the quality of care in the UK orthodontic services, which were, I think it was something like 80% removable appliances, most children or high number of children actually ended up worse than they were before they started because of the very simple system.

Payman: Clearly did.

Kevin O Brien: And what happened was, is that work from Steve led directly to several government inquiries, which then led to, I think it was a change of the method of payment and then fixed appliances sort of burst onto the scene quite suddenly. And I think part of that was due to the advent of smaller appliances, but also it was the method of the payment. In those days, remember dentists were paid on per item of service. So actually the thing that drove prescription patterns was how much you got paid for individual items. So orthos was lowly paid high volume, very basic. Whereas of course, nowadays things have changed quite dramatic. Yeah. To what Orthodontics service should be, which is mostly fixed appliances.

Payman: And the US at the time was way ahead because of this.

Kevin O Brien: US it’s always been based on fixed appliances rather than removable appliances. There were various reasons for that. First of all, the US trained more orthodontists at time than Europe. But secondly, if you sort of go back to the end of the second world war, the European States, and certainly the UK didn’t have much in the way of steel and steel was very expensive. So if you were to provide orthodontic treatment, you provide it with plastic appliances, with minimal amount of steel. Whereas the US of course, was steel rich and they could use fixed appliances probably far more than we could at that point. And then once you established a system of care, built around a very simple method, removal appliances it continues sort of driven by government and health service policy.

Payman: And when you became Dean of Manchester, was that sort of moving into the management side and away from the clinical side for awhile?

Kevin O Brien: I mean, well, one of the things that’s, I don’t know whether it’s fortunate or unfortunate about an academic career, but once you start to do good research. Because I was running a research team there. I picked up another grant from the Medical Research Council for 10 years funding to look at the effectiveness of early treatment for children with very prominent teeth. We were also piling research out every patient in the dental school, in the orthodontic department was part of the research project. I was working with people like, Steve Richmond, Nikki Mondale, who have all gone on to have great careers. And again, many young trainees that I worked with who are now quite high profile ortho dentists all came out of Manchester at that time because it was incredibly vibrant. So we were piling away at research. And then one of the problems is they going to ask you to take on an admin role if they see your research and you built a research team.

Kevin O Brien: I was made research director of the dental school. And then that often you often from that position to end up stepping up as Dean. So, that’s what happened. I ended up as Dean and well, rather reluctantly, I have to admit, I didn’t particularly want to do it. But when the university sort of says, well, we think you should do it. And this isn’t necessarily a request. It’s a sort of a, we’re making an offer you can’t refuse here. And that’s really what happened. I ended up as Dean, which I did for three and a half years.

Payman: That’s mentorship. You’ve taught thousands of students of both dentistry and orthodontics.

Kevin O Brien: Yeah, I think so.

Payman: First of all, can you tell someone’s going to be good early on and how early can you tell? And secondly, it must be like a source of real pleasure to you to see people blossom, who you’ve taught. I mean, is that what keeps you going in an academic role? Because as a private orthodontists, I’m sure you could have done very well, but you never did that.

Kevin O Brien: Yeah. I mean, my mom always used to say, why aren’t you a private orthodontist? There’s all sorts of terms that I have wondered that myself, I was once flying to… I’ll come back to your question in a minute, I was once flying to the American Orthodontic Conference in San Francisco. And as I was sort of sitting at the gate in the economy queue a load of specialists orthodontist, half of whom I had trained were boarded into business class. When I got on the plane, I found I was in the second row of economy. And of course you can see into business class in those days. And they were all waving to me and giving me food. But they came back and had a chat with me and things like that. It was a busy flight. So yeah, it does give me a great… I’m proud I think of all the people that I’ve trained in both specialists and general practitioners.

Kevin O Brien: It does surprise me actually, how many I’ve trained when I go to the orthodontic conferences. There’s always plenty of people that of course recognise me, that come up and talk to me. Yeah. It’s one of the things you look back on and think, well, yeah, that was great to have trained so many people. I actually don’t know how many, I worked at the university for 40 years. So you’ve got to think you’ve got an intake of 60 to 70 undergraduates a year.

Payman: And how soon can you see talent in even undergraduate and also.

Kevin O Brien: In undergraduates very quickly.

Payman: Really.

Kevin O Brien: We didn’t teach them much in the way of clinical orthodontics because that wasn’t our aim. Because we were treated them to be training dentists who were sort of to screen and refer at the right time and give advice because you can’t cover complex orthodontic treatment in the undergraduate curriculum. But I used to do seminars for students in years two, three, and five and lectures some critical work, but you could always tell them really good students within about one or two seminars. They would be expressing an interest. You wouldn’t have to prompt them, you’ll know the type. And you also know the people who are not going to do perhaps so well in these are the ones that tended to not engage or turn up late. And things like that.

Prav: Got sent to the Dean’s office.

Kevin O Brien: There were never sent to the Dean’s office but they got to know pretty quickly that if my seminar was timetable to start at nine o’clock, it started at nine. And that if they turned up 10 seconds late, the door was locked and they’d be whimpering outside knocking at the door asking to come in.

Payman: Prav asked that question because he spent quite a lot of time at the Dean’s office himself.

Prav: Yeah. So have you got any interesting stories where someone was sent to the Dean’s office.

Kevin O Brien: No. In those days, again, dental school has changed quite dramatically. The Dean of the school is… Once you took that job, you didn’t often come across the students on a day to day basis because it was a surprisingly high level job. And so you would delegate most of the day-to-day contact with people down to really, which was sub deans. So I worked very well with, there were associate deans in those days, two people a guy called Ian Mackey, actually, who was a brilliant undergraduate teacher and Ian dealt with all the undergraduate issues. I didn’t have to think about them because Ian had devoted his entire life to treating and teaching undergraduates. And it was only very occasionally Ian came to see me and said, we’ve got a problem. And that’s the way it tends to work. It’s a management role with a management structure beneath it.

Payman: Kevin, you spoke about your education, your specialism and the approach was very much a scientific approach, reviewing the literature, becoming a critical thinker. Has that changed in current day in terms of how the training is structured and what the output is?

Kevin O Brien: Yeah. In orthodontics in the UK, all the courses are pretty much the same. We have to teach the same curriculum. And that includes courses on research methods, obviously critical appraisal and everybody still has to do a master’s thesis which has changed over the years. It’s not as extensive as it used to be. So every specialist orthodontist in the country has had training in research methods, critical appraisal, and they’ve done their own piece of research or be it a small piece of research. So they know how to appraise the literature and how to appraise it critically. It’s not the same in other countries. European countries are pretty much the same. The US, I don’t think is anywhere near Europe in terms of training the specialists in science. I’ll try in english, it’s straight ahead out of the United States than within Europe.

Payman: What about the hands-on element side of things in terms of how much wire bending go or practical aspects of the course have changed? I know I was speaking to a couple of dentists, probably sort of my age or a little bit older, and they were just shocked and surprised at how, when they were at dental school, not obviously specialists, but when they were at dental school, the volume of dentistry they were doing as a student compared to students coming out now it’s like night and day.

Kevin O Brien: Yeah. I mean, it’s something that people often say. And certainly when I look back at my undergraduate training. I remember we used to go into sort of, as an example, here, we would have a block in war surgery, which lasted two weeks. And during that two weeks, I think you sort of had a requirement to take out at least a hundred teeth and do I think it was 29 oral surgical procedures. So at the end of the day, we certainly could take teeth out quite nicely. And we also used to do a lot of amalgams and a lot of restorative work and dentures and things like that. But those were the days where dental disease was absolutely rife. I think people who took a at modern dentists now and said, okay. And they say, they came to look at my clinic list in Middleton.

Kevin O Brien: They would be completely amazed at the amount of restorative work that we were doing. We were doing wall-to-wall amalgams and composites day in, day out because of the high levels of dental disease that we were dealing with. Clearances, dentures, immediate dentures, it was nothing like I imagine general dentistry is now. And I think that’s quite important. We were trained for the times, which was high volume, dentures, fillings, everything like that. And not necessarily to the same standards that people practise nowadays. I think that’s quite important. And then the biggest difference between an undergraduate newly qualifying now, and somebody qualifying when I qualified was the people understand what they’re doing more now than we did. We just did it.

Kevin O Brien: It’s as simple as that. You saw some caries. I mean, you didn’t have to look closely to see the caries. There was none of this agonising over, is this just a non [inaudible 00:21:14]? More often my thoughts were how close to the pulp is this before I get cracking. So times have changed and it’s often a mistake that people make to look back and think we weren’t taught the way they used to be.

Payman: And Kevin, you then took a role of the GDC, the way you’ve described yourself. It seems that would be a counter-intuitive move for someone who’s so into the teaching. And so into the research. How did that come about.

Kevin O Brien: One afternoon I spotted an advertisement from the GDC inviting applications for the chair of the specialist, dental education board. I’d always been interested in specialist training. And that was most of my work actually, to be honest. And so I thought that sounds quite interesting. I didn’t think about it being the GDC. I thought here’s an opportunity to help and perhaps change and improve specialist training for throughout the country. Because this was really, the GDC viewpoint on specialist training, right across all specialties. So I applied for that, trotted myself down to learn them. I didn’t prepare very much because I was busy. I think I was still Dean at that point. And I got the job. Hugh Matheson was the GDC president at that point and they appointed me and I did chairman of specialist dental education board for about two years.

Kevin O Brien: And then we came to the advertisements for the first appointed members of council. And I’d actually really enjoyed working with the GDC at that point. It was refreshing to see another outlook on dentistry from the point of view of protecting the public and that is their entire vision today. And I got more and more interested in this and this wasn’t protecting the public just in terms of fitness to practise. It was protecting the public in terms of levels of training, monitoring, audit, everything like that, that goes with it. So I applied to be a member of the council and I was completely amazed. Again, I was interviewed and I was completely amazed when I got an email one day, a few weeks later saying I was one of the appointed dentists on the council.

Kevin O Brien: At that point, the council was very large. It was 24 people. So I was one of the eight dentists on council and we had a 50 50 split between lay and sort of professional members. And that went quite well. And then Alison Lockie resigned. It was then going again for another chair. And my feeling at that time was that there was an inevitability and it is sort of a graduation that the chairs of regulators are laypeople. And most of the councils at that point had lay people as chair. But I felt that GDC wasn’t ready for that at that point. And so I got myself a bit cross. I was just in a cross mode and everything that was sort of going on with the GDC. So I thought I’m just going to do this. So I put an application in and was elected chair, which completely amazed me. I was quite stunned at this. My wife was completely shocked. I think a lot of people were shocked at it.

Payman: You don’t seem like the type of person who’s good at politicking, but correct me if I’m wrong, but I would’ve thought to become the chair of the GDC. You need to be that type, am I wrong about it.

Kevin O Brien: You need to be good at politics and it’s one of the things I’m not very good at politics. I’m pretty useless in many ways, but at that time, the politics weren’t that complex. It was getting the BDA back on board which I think was very important. It was getting the dentists back on board and I just quietly went about the job. And one of the things when I do look back that council did an awful lot of really good work in putting building blocks in place, right across the board, in terms of standard scope of practise, direct access specialist training, quietly got on with it.

Kevin O Brien: We made mistakes. Every organisation makes mistakes, but we just quietly got on with it. And I was quite pleased at the end with the work that we’d done. And my sort of feeling when I look back on it is, I’m quite happy now when I look back on it, because there are people that say to me, why you the chair of the council? And I said, yeah. And they said, well, we didn’t notice you. Well, that’s the best chair of a regulator you need is the person that I think is someone who just sits there, gets the job done quietly. And nobody really remembers them in about 10 years’ time because it was smooth and straightforward. And we sorted a lot of things out.

Kevin O Brien: I still managed to upset an awful lot of people and I wasn’t necessarily that popular in some areas of government. But I look back on that and I think we did a good job. And then that sort of leads us through to really a lay chair. The issue of lay chair is very interesting in the councils because the job has changed like all these things over the last 20 years, most of the regulatory bodies now have a lay chairs. I think the only one that doesn’t is the GMC. And that’s really unusual. I mean, I’m fairly confident in saying this. I probably am the last dentist chair of the General Dentist Council

Payman: Kevin, moving on from there and talking about GDP orthodontics. And there’s been a massive surgence of that, I think over the last decade or so. First of all, I guess I just want to get your opinion on how you feel about GDPs doing orthodontics. And what do you think is the appropriate training pathway for a GDP who wants to treat patients and straightened teeth and whatnot, and where do you feel the compromises are in a GDP assessing, diagnosing and carrying out orthodontics when obviously you’re comparing it to someone who’s had extensive specialist training.

Kevin O Brien: Yeah. So again, it’s always helpful to look back to sort of help you look forwards. When we look back, for example, in the time that I said orthodontic treatment was not carried out very well, I think I can’t remember the figures exactly, but I think it was about, there were a fair number of general practitioners who used to do orthodontics again with oral appliances, but there was also a group of practitioners who worked as critical assistance with consultant orthodontist, and actually the common pattern of care in sort of hospital-based orthodontics. And it’s not really hospital-based orthodontics as we know it now. Because the hospital consultant was often the only person providing orthodontics for quite a wide area because there were very few specialists. But what they used to do is they used to see patients, they used to write out treatment plans and either send that treatment plan back to the general dental practitioner that had referred the patient or send to one of the dentists in their district who would also do the treatment using simple methods.

Kevin O Brien: So they were doing simple compromise treatments in many ways under the supervision of a consultant. So [inaudible] orthodontic was not unusual at that point. Then of course, we moved into fixed appliances and this is where there is sort of a degree of a dilemma because it depends what you’re trying to do. So for example, on the undergraduate orthodontic course, there is absolutely no way I could teach eight year undergraduate students to be competent in fixed appliance treatment. Even the diagnosis that’s necessarily behind that. There’s no doubt that that is a specialist subject is most fixed appliance treatments for children are specialist level. That’s not to say that a general practitioner, who’s got a lot of experience in treating children with fixed appliances should not be doing it. And there are many of those around, to be honest, who do a very good job, despite the fact that they’ve not had a specialist training, they’ve sort of learned it over the years.

Kevin O Brien: Yeah. As an example of that, and it’s a bit of a spin off when membership in orthodontics first started, there was one year where there was a moratorium in a way, they called it a moratorium, but I refer it to the called an opportunity. Where experienced general practitioners could come and sit the specialty exam. If they wanted to give it a shot, they had no specialist training. And I examined it in those days. And they were, I think it was about 10 to 15 people who were experienced general dentist who actually took the specialist exam and they passed it easily. They’d have 20 years of experience. So there’s that sort of experiential way of gaining sort of specialist level experience in orthodontics. But really it’s now a dilemma in many ways, because I’ll go back in and there’s no way I think that anybody can quickly and with a reasonable length of time, learn to provide specialist level of orthodontics to children without going on a specialty training programme.

Kevin O Brien: That’s always my advice. Lots of people ask me what do I do to be a specialist or to get good at orthodontics? I’d say your first course of action is always consider specialty training programmes because that’s where you learned to do it very well properly and very effectively. But then we’re sort of getting to that middle stages. Are there groups of people who can have orthodontic treatment that doesn’t require specialist training? And the difficulty here is recognising when you can compromise because you can’t argue that in order to take the decision on whether to compromise and make a treatment simple, you have to be a specialist and specialist thoughts, compromise orthodontics is nothing new. Specialist orthodontists have been doing it for years. You sort of look at people and have discussions in terms of what sort of treatment the people want to undergo. And for years, and I’ve done it with a lot of the kids, I used to treat in the children’s hospital in Manchester who had severe medical conditions.

Kevin O Brien: They couldn’t cope with lengthy orthodontic treatment. And we’d go for a compromise, which in effect would be straightening up those front six teeth. That sort of the concept to the social six. And that I think where mentoring schemes come in now and sort of a certain GDP courses is that there’s nothing wrong. I know several people do this online now, there’s provide online advice to dentists about what treatment can be done as a compromise that would do someone a reasonable amount of good because a lot of adults just want their front six straightening. They’re not interested in the molar relationships or extractions based closures or anything like that. They want to improve their smile by having their front six teeth straightened.

Kevin O Brien: And as long as they know that that’s the compromise and it’s being done by a general practitioner under monitoring, for example, and in a way that perhaps is the contemporary sort of model for the consultant orthodontics service monitoring treatment that I talked about previously, then I think there’s nothing wrong with it. What is clearly wrong though is people being sold courses? Oh yeah, we can do treatment better than a specialist. You just have to come to an airport for a couple of days to learn how to stick brackets and change the wires and off you go.

Kevin O Brien: So that is not correct, but monitored GDPs learning on the job as they go through over several years, creating relatively straightforward adult cases isn’t a problem. I don’t think there’s any orthodontist would disagree with that, to be honest.

Payman: But, Kevin, if a young dentist was going to go on a two day clear aligner course and then provide clear aligner treatment, you were saying that’s compromised treatment. Right. Is that where you’re at?

Kevin O Brien: Yeah. I mean, to be honest, I might get criticised for this. A lot of the aligner treatment is compromised treatment anyway, in many respects, I think it’s-

Payman: Let’s get to that. Yeah. How good is Invisalign from your reading. Is Invisalign better than the other clear aligners and then how do they all compare to fixed?

Kevin O Brien: Okay. So research is showing and research is now starting to be done. And it’s difficult to do research in this area because aligner treatment is very different from fixed appliance treatment. So if someone really needs fixed appliances, they should be getting it. I think that’s the first call. Certainly I’ve never done a aligner treatment. It’s bypass me completely. But in discussions that I’ve got with specialist friends of mine who do aligners, their first offer of treatment is for works fixed appliance treatment. And then that sort of explain that anything else is a compromise. Aligner treatment has to be quite a compromised because you haven’t got the control that you have with fixed appliances. You do see aligner treatment and some practises that are a hundred percent aligners. But research is showing actually that fixed appliances are still providing a better sort of finish and better standard of care.

Payman: How far behind is generally research from, for instance, I’m sure, if you spoke to the people that align they’d tell you, look, what we provide this year is a lot better than what we were providing three years ago because of machine learning and whatever they want to say. Yeah.

Kevin O Brien: Yeah. People always say that. They’ll always say, there’s always something better around the corner. And that’s what we like to hear. Isn’t it? That there’s always something better and companies do that. And it’s perfectly within their rights to do that because it’s the job of the salesman or the salesperson is to sell them appliances.

Payman: No, I get it. Like a healthy dose of scepticism, definitely from someone like you needs to be, that’s really super important. Right. But as a question, if a Tif Koresh type person, not someone in the highest echelons of ortho, yeah. Someone in practise actually came up with a breakthrough. How long would it take before that breakthrough gets onto an MOF course in Canada? I would say 30 years.

Kevin O Brien: Yeah. I mean, that’s the way things are. Research takes time because of course the length of treatment is lengthy. There’s no doubt about it. You’re looking at two and a half years, the average course of treatment, the early treatment class 11 studies that we did that took 10 years to do. And it was one of the studies that completely changed the viewpoint on orthodontic treatment with functional appliances and there were several studies doing similar sort of thing. And we changed the way orthodontics was done.

Payman: So how long was it from the time you started that work to? Is that now taught on Mos all over the world?

Kevin O Brien: Yeah. It’s-

Payman: What the timeframe?

Kevin O Brien: The first part of the studies took five years to do the papers came out very quickly. So they were on the courses within five years. And then they’re classic papers. It is one I think.

Payman: You’re highly prominent person. Yeah. So if you discover something it’s going to get onto the course as much more quickly than if for even Align, discover something. But.

Kevin O Brien: It’s the quality of the research that’s done. So I think the issue is I’m always going to be faced with this is that we need to be… There’s nothing wrong with producing new treatments and saying that things are changing. Self-ligating Classic, absolutely classic thing is self-ligating was heavily promoted. It was going to reduce extractions. Everything would be much faster. It was going to be brilliant and the companies promote it that quite strongly. Then key opinion leaders started talking about how good self-ligating was. And self-ligating became very popular, but then what happened is the research caught up. Actually there is absolutely no difference between self ligating bracket treatment and classical fixed appliance treatment. And we’re seeing this constantly, we’ve got things like AcceleDent the orthodontic vibrator, everybody was making claims that that speeded tooth movement, but it didn’t. Yeah. Vibration doesn’t work, all sorts of things, speed treatment just don’t work. There’s no evidence that they work.

Payman: Does that decortication speed up treatment.

Prav: Does that the one they drill in.

Kevin O Brien: That doesn’t work either.

Prav: That doesn’t work either.

Kevin O Brien: No. The thing that influences the speed of orthodontic treatment is the operator. If you’re a good operator and you see your patients every four to five weeks, it’s quite surprising how fast your treatment goes. Potions, pills, trauma, vibration doesn’t help anybody even the good operators. When you look at trials of surgery, for example, it is not necessarily always the technique that comes up with the best results. It’s the skill and the care of the surgeon. And that’s the same with orthodontics. If you know what you’re doing and you see your patients regularly, you finish them quickly.

Payman: Kevin, How did you feel when you first saw Invisalign. Did you think?

Kevin O Brien: I was very interested in it. In fact, we approached Invisalign to say, do you want us to do a trial?

Payman: Really.

Kevin O Brien: Because we were trialling everything. We had Invisalign managing come over and meet us in Manchester. And we explained to them what a trial would involve and everything like that. And the time and the cost. And all we got was at the end of the day was the bottle of Californian red wine, which was nice, which they left for us.

Prav: Which year was that?

Kevin O Brien: Crikey, I can’t remember it must’ve been mid 1980s when Invisalign was first coming out. So there’s nothing wrong with the aligner treatment. I need to stress this. Aligner treatment is fine. It works. Expertise got to be really good at it. And you do see some nice results, but because it’s a removable appliance, you’re never going to have the control that you’re getting fixed appliances, but it’s revolutionised orthodontic treatment, it’s revolutionise adult orthodontic treatment without a doubt. But most of it is a degree of compromise, but there’s nothing wrong with that compromise. The danger you get is when someone goes on a course and they think they’re a master of the universe and can do everything. And that’s where things go as wrong. And that’s down to the individual practitioners and their confidence and their scope of practise and overall professionalism.

Payman: Just going back to the GDP also. Have you seen many cases that come back to you having gone to an airport course attendee where you look at those cases and you think, Oh dear, if only they knew how to identify and the reason I’m mentioning this is numerous conversations with Ross Hobson have the main takeaway point from him is always, you don’t know what you don’t know. And the most important part is knowing when to refer and when not to treat.

Kevin O Brien: Yeah, that’s it. I mean, we try and teach undergraduate when to refer and when not to treat, I think that’s the most important thing. Yeah. I’ve seen loads of people who have actually had harm from being treated badly by people who have got involved with some of the airport courses. Where we’ve taken years to get them back on track. Having said that it’s subjective. And again, talking to colleagues, I can’t help wondering if that started to die down a bit. We go back into the 1990s and there was a fair few people peddling, quite poor treatment to the airport courses, both with fixed appliances and unremovable appliances and expansion plates, and thinking that you can grow jaws and all that business that sort of died out recently. I can’t help wondering if there’s sort of been an evolution. Perhaps with great opportunities that really interested practitioners have had to sort of be mentored and work with other people.

Kevin O Brien: Yeah. The whole thing about it is you can be trained in something. It doesn’t necessarily need to be a three-year course, and you can be trained in anything with mentorship programmes or working alongside people. Remember that was the way it used to be done. That was the way dentists used to be trained. But what you’ve got to understand as a professional is your limitations and you don’t know your limitations, you should know your limitations completely. Ross’s right. Is what you don’t know is the problem. And when people think they know it all, and that they go back to saying that they think they know it all and can do everything with Invisalign. That, for example, that’s where they run into problems. It’s not the appliances, it’s the operators and it’s the way they behave. And some of them, unfortunately, don’t recognise their limitations. They’re working outside their scope of practise and that’s where harm occurs.

Prav: SO, Kevin, tell us about your website. How did that come around? When did you have the idea or the brainwave to say, hey, I’m putting up a website and published some information online.

Payman: And how massive it is.

Prav: So my blog now is read pretty much half a million times a year.

Payman: Lord.

Kevin O Brien: I’m a little bit worried. I’m getting obsessive about it this year now. Because it looks as though we’re going to fall below half a million. We took a big hit in the COVID crisis, which surprised me is readership dropped during the world lockdowns. I think that shared the state of mind and that degree of worry that people have hard and are still having, so this of course is a funny year. So I started it as I’ve just finished as GDC chair. And I was getting a bit bored really. And I’ve always been interested in computers, right from the start I’ve bought things like [inaudible] and everything like that. My son is also pretty heavily involved in social media infact that what he does for a job.

Kevin O Brien: So he was sort of talking to me about blogs and that sort of business. So I thought why don’t I start a blog. So I ordered a book on how to write a blog, which just takes you through a step-by-step on how you set it all up. And this is a surprisingly interesting, easy thing to do. So I went to a web hosting company, which charged me 10 pounds a month, read my own blog using free WordPress software, which again was fairly straight forward. And I published my first post five years ago when the British Orthodontic Conference was in Manchester. And I just learnt about the latches that I’d been to see and what I thought of them and I just sort of posted it up. I mentioned it to a few people and it was read by 20 people in a week.

Kevin O Brien: And I was quite pleased with that. And it continued just to slowly grow. And then suddenly after about six months again, I was talking to my son and saying, I’m doing all right and getting about a thousand reads a month. What can I do to boost it? And he sort of looked at me and he said dad, have you heard of Twitter and Facebook? I said, yeah. He said, okay, open those accounts. Set a Facebook page up, I’ll give you a little bit of a hand with the phrasing and let’s see what happens. And the whole thing exploded at that point. The readership just increased massively. And so now it’s read all over the world. Each post is read at least 6,000 times on its first day. As you know probably had to upgrade my website and servers because I was crushing the servers that I was hosted on.

Prav: Is proud thing your website.

Kevin O Brien: I did the website.

Payman: What I found really interesting Kevin, when you came to see me is I was just absolutely amazed at how you’d set it all up on your own and you right it is incredibly easy, but it’s surprising at how many people can’t do that.

Kevin O Brien: I have always messed about with computers.

Payman: Yeah. And no disrespect to your age or anything, Kevin, but when someone you comes along and then you’ve got a website and it’s got so much traffic, I was looking at it thinking, wow you’ve achieved this all by yourself, but you’d got it to the point where it was crazy. And I don’t know if you mind me saying so, but I remember you sticking the donation page on there to sort of open and fund it and just speaks true testaments to the followers and the value, they get out of it. When you sort of put an ad out there to say if you’d like to donate to support this, and you can tell the story if you want Kevin in terms of what happened after that.

Kevin O Brien: Yeah. I mean, that was it. I mean, I used to support it for my lecture fees and things like that. An honorarium that I received from giving lectures. But then I thought the decision that I was going to stop lecturing because I wanted to spend more time with my family and as great as it is being an academic, being flown all over the world to give lectures. And it’s not being churlish or not grateful, but it takes up a lot of your time if you’re giving lectures at large conferences. So I’d taken the decision. I was going to stop doing that. So the source of income from a plug had dropped also coupled with the fact that if you want to professionally written website and professionally hosted, it cost a reasonable amount of money.

Kevin O Brien: Hosting isn’t costing 10 pounds a month anymore. So I decided let’s just see what happens. And when I open donations page. And I had to close that page within a week because my accountant said, if you’re not careful, you’re going to be paying tax on the donations here. And people aren’t giving you money to pay tax to HMRC. So yeah, we closed the first donations after a week. I think I’ve got about 9,000 pounds on that within a week.

Payman: Wow.

Kevin O Brien: Interestingly, a lot of this was from the year US, the big donations were from the United States where people sort of have a giving culture, and I think they get various tax breaks. And there are people now working up the donations page, every April, I’ll do it about April the fourth for the tax year. And there were two Americans immediately donated a thousand dollars straight away and having being so consistently. And so I covered my running costs. The donations page this year took a little longer because I think of the times, but I had to close it after about two and a half weeks this year. And people still come into me and say, can we make a donation? I say, now I can’t, because I can’t make a profit from donations. It would be the wrong thing to do.

Payman: And there Lies the answer to why you decided not to become a private orthodontist.

Kevin O Brien: Yes.

Payman: Can I give you some money, Kevin? No, thanks.

Kevin O Brien: No, it is that several people have said to me, why don’t you charge for this one? You charge a pound to read it, because obviously that would make a considerable amount of money. But all I’m doing is sort of I’m writing posts on my viewpoint, which is occasionally controversial, but all I’m doing is putting my interpretation of research papers and explaining the good and the bad things about them. I’ve also been joined by Patrick Fleming, he is professor of orthodontics down at the London hospital. And so there are now two of us writing the posts, but we both believe that education in many ways should be free. And I think it is important to think that actually there’s an awful lot of the readers of this blog are from, When I look at the readership, most of it is United States because of the concentration of orthodontists and then sort of the Western part of Europe.

Kevin O Brien: But then we move into other countries in which training isn’t always available, resources aren’t available to the degree that they are. Dentists and orthodontists generally are not as wealthy as they are in other countries. And so we get a lot of readers who are actually very grateful to be having something for free because they haven’t got the money, for example, the spend money. So it is that concept, that education, if we can do it for free, it should be free. And that’s what people’s donations in fact are paying for, which I think is good.

Payman: Do you get much stress from it? Does the AcceleDent contact you and say you just ruined our business. Do you get trolled?

Kevin O Brien: The times when I’ve turned it up. There’s times when I’ve crossed the line with people and I’ve thought, shall I post this? And I thought, yeah, maybe, and then I’ll hit send. But no, it’s not stress. I quite like doing it. It only takes me about half a day, a week to do it. Doesn’t take long to write one most of the time. And then the remaining time is editing it and getting search engine optimization and all the other stuff that goes with blog posts, so it doesn’t take me long. I like doing it. It’s something that I like writing and I like writing about stuff and explaining things to people. And Patrick does the same. The only time that I got stressed a lot was when I was sort of attacked by quite a few key opinion leaders in the United States. They said some pretty unkind things about me. It caused me a bit of stress, but then I thought, hey, how.

Payman: Because of what you were saying about them, were you were saying-

Kevin O Brien: It was a pretty blunt attack on key opinion leaders who are promoting treatments without evidence. They were sort of being clinical salesmen. I was blunt and they let me have it, but a lot of their comments weren’t nice and it troubled me a bit. But then I thought, well, this is the world of the sort of social media. They can sue me if they like, I thought, yeah, my business that supports the blog is worth a pound. And I don’t intend to go back to America for quite a long time. So it was more tougher ducks back, but it did trouble me for a couple of days, but then that’s why I think that’s a fact of life. Occasionally, if you’re not upsetting people, sometimes you’re not getting anywhere.

Kevin O Brien: And it is something that I feel quite strongly about is paid key opinion leaders. You get six figure sums from some of the companies and you start lying about the products that they’re trying to sell. So yeah, this not as a key opinion on slot every couple of months or so just to knock them back into shape. And that’s one thing that the blog does quite nicely, but it’s mostly educational. I’d hope it’s mostly educational.

Payman: I think I’m conscious, we’re both running out of time. So one thing I wanted to address Kevin, I’m fascinated by the sort of the aura that orthodontics has managed to get for itself. I get the same dentist saying to you, I don’t know if you know, Kevin but we’re in teeth whitening and composite bonding. I get the same dentist said to me I’m not interested in teeth whitening that’s cosmetic treatment, but refers loads and loads of kids and things for ortho. And in the back of my head, I’m thinking, well, orthodontics is a cosmetic treatment. I mean, how much of orthodontics has health benefits and I’ve noticed that there’s quite a lot of dentists selling orthodontics based on the health benefits of it. How do you feel about that?

Kevin O Brien: Well, we’ve just done a paper that was published in the American Journal of Orthodontics that in fact said that there was the surprising lack of evidence for the benefit for orthodontic treatment across the board. Now that’s not to say that that isn’t a benefit. And I think it’s very important to stress that is we didn’t find any evidence for it or much evidence for it. And the reason for that is that we’ve been asking the wrong questions. And most orthodontic research for example, is involved with how straight are the teeth, what someone’s skeletal pattern and things like that. Which we haven’t sometimes very little in a way of actually asking patients the way that they benefit, how do they feel? And those are very important factors. So when you look at the benefits of orthodontic treatment, you’ve got the various non cosmetic benefits such as treatment of impactions, large overage that are subject to trauma in young children, severe crowding, which may lead to tooth decay and periodontal Poppins.

Kevin O Brien: But that crowding has to be severe. The crowding that most of us see even on a referral practise is not going to lead to increase caries or periodontal disease. So then you sort of look and think, well, the cosmetics that is important too. We go back to the appearance of people’s teeth. And again, over the years, this has changed quite dramatically, predominantly I think because people becoming more aware of themselves and their appearance and societal norms have changed. And again, we’re all much more aware of our appearance than we are used to be. And just in terms of the way we look our way to narrow and all that, because we’re photographing ourselves all the time. And when you then transfer that back down to the generation of teenagers now, and certainly for the last five years with selfies and photographs and posing and everything like that, I would say, and this is just a hunch because there’s no science behind this that are sort of young people that we treat or seeking treatment are very different from those from 20 to 30 years ago.

Kevin O Brien: And they are concerned with the appearance of their teeth because of that great importance that’s placed on appearance. And that’s what you’re treating, you’re treating someone’s appearance. Now the next question then is that treatment of someone’s appearance cosmetic. And at what point does improving or changing someone’s appearance become a health benefit in terms of their overall way they feel about themselves and their self-esteem and their various interactions, because then you sort of move into sort of mental health benefits. So there’s only been one study that has ever really looked properly at self-esteem and orthodontics, and that was done by us. And it was part of the class 11 studies that we did looking at interceptive treatment of class 11 problems in young children. And we found that a group of children who received functional appliance treatment these were kids with big overjet. When that overjet was reduced, their self-esteem boosted, and they were getting teased less.

Kevin O Brien: What then happened when we followed them through for the next five years, the kids who didn’t get treatment early caught up with them in terms of their self esteem. So there was no difference in their self-esteem when they were 16, but there was when this group of patients were nine or 10, and that might’ve been very important and we didn’t measure it really now I’m kicking myself to say, if I did that study again, what would we do many other things. So there is something to it. It’s easy to say it’s just cosmetic.

Payman: I’m all for it being all cosmetic, don’t worry. But it’s the fact that it’s wrapped up as health that I’m interested in because teeth whitening has health benefits, by the way.

Kevin O Brien: That’s what we don’t know about artist. It depends what you call health.

Payman: Well teeth whitening is good for the gums in terms of the peroxide is good for Gingivitis. You get less plaque adhesion to the teeth. You get less root caries but we don’t talk about that because it’s the cosmetic side we talk about, but-

Kevin O Brien: But you don’t measure you see remember health isn’t just bodily health. It’s also mental health. WHO definition of health.

Payman: Of course.

Kevin O Brien: And it is, I can’t quote it exactly at the moment, but there is something about social, psychological health.[crosstalk 01:00:34]

Prav: Sorry to interrupt you. But you’ve been very evidence-based and looking at research and all of that. I’m going to ask you a question. That’s maybe counter-intuitive now, what’s your hunch. I know you probably don’t like talking about hunches cause you like evidence, but what’s your hunch on the future of orthodontics? I mean, what’s got your attention in the near future and talking a bit further ahead, is this idea of machine learning AI and all that. Do you think that’s really going to work? Do you think direct consumer is going to get to a point where we don’t need orthodontists because of the technology?

Kevin O Brien: Yeah. Orthodontics reinvents itself every few years because there’s the cycle after cycle of new appliances, nothing is new, self ligation wasn’t new. It’s been around for years for example. So breakthroughs in orthodontics I would like to see a method of making teeth grow faster and in the hands of good operators, you’d see no reason why that shouldn’t happen. There must be improvements in the cosmetic look of our appliances. We are moving that way. There’s got to be a movement away from steel. We’ve had ceramic brackets for a while, but they’re still not as good as steel in many ways. So we’ve got to move away from that. I think the trouble with direct to consumer care is I don’t understand how you could do it in terms of looking after the patients properly.

Kevin O Brien: I think that’s the key issue. Tele dentistry and everything that is fine and it does work. It’s worked telemedicine and tele dentistry is working. So there’s a lot of scope for that, but all that involves is constant monitoring and looking after people. So I think that at the moment, direct to consumer, no matter how fancy they try and dress it all up is not going to compensate for the orthodontist or dentist detecting something going wrong and changing their treatment.

Prav: At the moment I think it is a disaster, but do you think going forward it could become a thing or?

Kevin O Brien: I don’t understand how it could without that contact of the professional, with the person who knows what they’re doing. I think that’s the issue.

Payman: Kevin, What you were saying earlier is a dentist who’s done a five-year degree, has been on an airport course and sees the patient’s mouth in their chair can still mock it up. And now we send some Potsy off to the patient and say, take your own impression, sunshine, and we’ll straighten your teeth.

Kevin O Brien: Yeah. So that’s the issue there the dentist working outside their scope of practise, it’s not the system of care that’s causing the problem. It’s the dentist. And we will never eliminate people who work outside their scope and make mistakes. It’s a risk that we all take. And that probably is quite small. If you think about it. Because I think most dentists are sense of a line. Most health care professionals don’t want to harm people.

Payman: No.

Kevin O Brien: They don’t mean to. They don’t like mistakes, but mistakes happen and that’s life. But if you’ve got nobody looking after the patient, even if it is just simple aligner treatment, it can go wrong. And I think it, from the point of view, protection of the patient, that’s quite important is that the patients still need protecting.[crosstalk 01:04:22]

Payman: If Kevin O Brien was going to design a direct to consumer system. What would it involve? Would it have a dental monitoring thing with a patient taking a picture every day or what?

Kevin O Brien: Yeah. That’s how, I mean, orthodontics is delivered like that in some countries, it’s the way that some people are, I think people that live in remote areas, the orthodontist is on the end of a computer instructing dentists on what they should and shouldn’t be doing, that is remote treatment. Is not direct to consumer though that’s the issue. The thing that’s missing out of the direct consumer is the protection of the patient by the professional. We always have to go back to that is as we’re all professionals and that’s the way we should be acting. And you take that out. You’re going to have problems.

Payman: Kevin, give your blog a quick plug so that people know how to get to it. And then Prav ask one final question. I know you-

Kevin O Brien: Yeah. Getting to the blog is easy. Just type Kevin O’Brien’s orthodontic blog into Google and you’ll find it.

Prav: Excellent. Kevin, my final question, we ask everyone this, imagine that your last day on the planet, and you’ve got your family around you, what three pieces of advice would you like to leave them with? And to finish that question off after that is how would you like to be remembered?

Kevin O Brien: I would always say in terms of advice to people is be kind, be calm be mindful. Don’t stress too much about everything, how I’d like to be remembered. I suppose I’d like to be remembered as someone who did make a difference to orthodontics and dentistry really. I’m quite pleased with what I have done. And I suppose I’d like to think, well yeah right I helped good changes to dentistry and orthodontics in what I’d hope is be quite a gentle, but very occasionally a bit of an aggressive indefinite way. And I suppose that would be about it.

Payman: Brilliant.

Prav: Thirdly, you certainly have made a massive difference to orthodontics and dentistry. No doubt about that. It’s been wonderful. Thank you so much. I’m sorry. We had to run out of time like this. I know you’ve got to run yourself, but it’s been brilliant. I feel like we need to see you again.

Payman: Likewise.

Kevin O Brien: Anytime you like. I’m off to go and increase the income of a local vet.

Prav: Thanks, Kevin. Thanks a lot.

Kevin O Brien: Okay. See you soon. Take care.

Prav: Bye.

Outro Voice: 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.

Prav: Thanks for listening guys. If you’ve got this far, you must have listened to the whole thing and just a huge thank you from me and Pay for actually sticking through and listening to what we had to say and what our guests has had to say, because I’m assuming you got some value out of it.

Payman: 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 much for listening. Thanks.

Prav: And don’t forget our six star rating.

In one of our most packed episodes to date, we catch up with Love Teeth’s Kunal ‘Dr K’ Patel.

Kunal lets us in on his early days as an angry young man, his unusual entry to dentistry via training in the Czech Republic and how a seemingly routine job interview at his Cheam practice changed everything. 

And it’s an unplanned double-bill as Kunal’s wife and co-entrepreneur Lucy Patel sets the record straight.

Enjoy!

We’re like Pinky and the Brain. We wake up and say, “What’s the plan today?” And he goes, “Take over the world.” – Lucy Patel

In This Episode

01.31 – Early years

06.50 – Reality Czech

13.53 – Back in the UK

17.56 – Purchasing a practice

22.07 – Making friends and influencing

26.26 – Love Teeth and being seen

35.46 – Building value

42.14 – Wedding Smiles

46.02 – On marketing

48.07 – Love at first sight

01.08.48 – Finding fame

01.18.34 – Lucy enters the fray

01.20.42 – Love at first sight – Lucy’s version

01.27.24 – Team happiness

01.32.05 – Future plans

01.36.40 – The Love Teeth experience

01.42.14 – Family life

01.49.44 – The question

About Lucy and Kunal

Kunal Patel is the owner of Love Teeth dental clinic in Cheam Surrey. He is an Invisalign Diamond Apex provider and a FastBraces Senior Master Affiliate. He also runs the successful Wedding Smiles brand.  

Lucy Patel is a dental nurse, aesthetic therapist and manager at Love Teeth.

Lucy: … and he wraps this cardboard box up in wrapping paper, and she opens it up and it’s empty. He goes, “Oh, [Keira 00:00:08],” as you do. “Keira, I’m so sorry. It’s been really hard at the moment. We haven’t been able to see many patients. We haven’t got any money at the moment.” She goes, “That’s okay.” She goes, “I can do so many things with this box.”

Intro Voice: 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.

Prav: It gives me great pleasure to introduce Kunal Patel, one of the rising stars of dentistry; Set up Love Teeth Dental, and him and his wife put his local area on the map. One of the largest and most prominent Invisalign providers in the U.K., and has recently refurbished his clinic to look like something amazing.

Payman: A rapper’s clinic!

Prav: I was actually going to say he’s pimped it out. But he spends most of his weekends and his Instagram stories doing Bob the Builder DIY, pimping himself with his favourite sticky-back plastic for Blue Peter and carbonising everything.

Prav: Kunal-

Kunal: Hello.

Prav: Take it away, buddy. Tell us where you grew up, and a little bit about your back story growing up.

Kunal: Right, guys. So I was born in north London. It sounds like Fresh Prince. I came down to Surrey, and this is where I’ve settled down. It’s the family home with my parents, my young family, and I’ve bought a clinic five minutes away from home.

Prav: But growing up, Kunal, just tell us a little bit about your childhood. What was it like in terms of the upbringing?

Payman: What kind of a kid were you? Were you hardworking or not?

Kunal: Yeah. I was quite a confusing kid because I think my parents would say that I was really good for many years and then all of a sudden I turned. So growing up, it was north London. Moved down when I was about seven. I went to a normal state school for a while and then, at the age of nine, my mom decided to put me into a private school just to get me into a good 11-plus high school.

Kunal: So for a year and a half I went to a private school. So I lost all of my friends, went to a new school, and, for some reason, at that age, there was influences around me… Because I was quite a really good, studious kid. I was head of year at my old primary school, that type of kid. Then in year… I think it was year 10. No, year 7, just before 11-plus, I got in a bit of trouble at school. For some reason I went into the kids’ changing rooms and smashed everyone’s lunchboxes up, and I started turning into a bit of a naughty kid.

Prav: Was that at private school?

Kunal: Yeah. It was at the private school. So I changed from a state school where I was a really popular kid. I went to this private school, and I wasn’t allowed out to play with the other kids at lunch because I was the naughty kid.

Kunal: I was applying for Tiffin Boys, which was one of the top state schools in the country at the time, in Kingston. The headmistress said, “There’s no point applying. Your son, there’s no chance he’ll get in,” and I was the only kid that got in in the whole year. It just proved that there was something going on in my life and at the time I didn’t understand it. Only recently I’ve probably understood what it was that was going on in my life, and it was external factors, family life, et cetera. I wasn’t that happy kid anymore. I turned into a bit of an angry kid.

Prav: What was it that transitioned you from being this grade A equivalent of super goody-two-shoes to smashing people’s lunchboxes up? Was it the transition from state to private, losing all your friends, and you thought, “Screw this. I’m just going to go nuts,” or was there something else going on in your life?

Kunal: I think moving so much as a kid, I didn’t really have friends, right? I wasn’t that kid that was hanging out on the streets playing with friends or anything like that. My friends were only my family. So it was my close cousins, my brother, my home. Obviously there was things must have been going on when I was younger, and I just wasn’t a happy kid anymore. I was a bit lonesome, and, I guess-

Payman: How long did that last, Kunal?

Kunal: You know what?

Payman: To this day?

Kunal: No joke, I think until the age of 23.

Payman: Wow.

Kunal: I think I had a big change in my life when I was about 23. Up to that point, I was… my friends that knew me back then would have said I was an angry kid. Could have been short man syndrome, I’m not the tallest, but there was something that wasn’t right with me. My family always said I was always a smart kid but-

Prav: Kunal, just in terms of that, angry as in short-fused, angry as in miserable? What was it, man?

Kunal: Yeah. I was just getting into fights.

Prav: Scrapping.

Kunal: Yeah, I was scrapping a lot. I was just picking fights. I would have this mentality that I had to protect everyone around me. So anyone saying anything bad to someone that I thought I liked… Because, as I said, I didn’t really have friends friends, and I was always trying to make friends and make people like me. So, I guess, if someone said something to a boy I liked, I would go and scrap them.

Kunal: Then I was about 17, 18, doing my A-Levels, and then the fighting became a bit… as you get older, it becomes a bit too much, right? It changed from just fist fighting to people having weapons, et cetera. So me and my family decided, “I’m moving abroad. I’m getting away from this.”

Payman: Is that right? So then do you remember the time when you thought, “I’m going to be a dentist”?

Kunal: I-

Payman: Doesn’t really fit in with this fighting kid.

Kunal: No, no. As I said, at a young age I was… I was the youngest. My dad’s got seven brothers, and I’m the youngest kid on my dad’s side of the family. I remember my oldest uncle always said, “Kunal’s going to become a doctor.” So, in my head, I was just becoming a doctor. Being Asian, there’s only two or three things we can do: dentist, doctor or-

Payman: There’s loads and loads of dentists in your family, right? Amongst the cousins, there were already lots of dentists, right?

Kunal: Yeah. So we had a few dentists, lots of medics. There was a lot in both sides of the family. I was the youngest. I was the most, in a way, loved, because I was the youngest kid. So I was like that golden child. There was a big age gap. Me and my brother have five years. Me and my sister have seven years.

Kunal: So we got to that age, the fighting wasn’t ending. It was really distracting me from my studies. I knew I could do better. I then tried A2 level to move again. I moved away to North London. I went and stayed at my uncle’s house, there for a year. Did my A2 there. So I left Tiffin Boys, which was a great school at the time, to go to another private college. So I left my friends again. [inaudible] work out.

Kunal: Then me and my younger cousin, who finished his A-Levels, decided, “Let’s go to…” Opened the newspaper and… I came from a wealthy family, and one good thing that my parents did for me was I never knew I was wealthy. I never knew. I didn’t really have friends to compare with. They never made out that we were wealthy. I just thought it was normal until one day my friend said to me, “Wow, your house is like twice the size of mine,” and I still didn’t get it.

Kunal: But I must, in that mindset, had a rich boy mentality because I opened that newspaper that day and I said, “Oh, wow. Look, we can become dentists in Czech Republic. Let’s just go.” I thought mommy and daddy would buy me a dental degree. Got my cousin, I said, “Let’s go. Mommy and Daddy are going to buy me a dental degree.” So we signed up. We left. We landed in Czech Republic. A minibus picked us up, two little 18-year-old boys. It drove for two hours. We thought we were going to Prague.

Payman: What, you didn’t realise it wasn’t in Prague?

Kunal: No. By the time we ended up being at the location it was dark. We were nowhere near a city. This person that could barely speak English took us up to this hostel room. It was a hostel. Dumped us in there, gave us a piece of paper and said, “Somebody will be in contact in the morning.” Nobody came for about two days, and me and him-

Payman: Take us through what was going through your head.

Kunal: We called home, and that movie, Hostel, came out that year. We called home and we were crying in tears, saying, “Please take us home, Mommy and Daddy.” They flew out a couple of days later. My sister came, my mom came, and my uncle came. I think they were shocked, but they didn’t want to say it. They scrubbed up this little flat. It was so weird. They used to have a bathtub with a sink inside it and a toilet right next to it. It was like, “No way. This isn’t how it’s going to end up.”

Kunal: They begged us to stay for a week. We would cry ourselves to sleep every night. I remember when they flew back to England, me and my cousin literally hugged each other and cried ourselves to sleep listening to Boyz II Men. It was-

Prav: Sounds like something out of a horror movie, mate.

Payman: Sounds like you needed it though, man. Sounds like you needed that.

Kunal: No, no. Exactly. This is what I’m going to get to. A few weeks later, there was a lot more of us spoilt, little, rich Indian boys that ended up in a dump in this hostel. We formed a community. There was, what, 150 of us. But this was the problem: only five of us graduated at the end of that 150.

Payman: Wow.

Kunal: In five years. And-

Payman: Why’s that?

Kunal: I think it was the best thing that could have happened to me because we had to speak Czech. We had to read Czech. We had to be able to write Czech. In our first year, at the end of it, they would give us a tooth and made us, in a timescale, drill an MOD cavity in a timescale, and the examiner will look at this with binoculars measuring the angles. So if you weren’t naturally gifted as a dentist, they’ll kick you out. So the whole mindset was different. It was me thinking that I could pay for a degree. Yeah, you can pay to get into university, but to pass is a different story. Half the uni got kicked out in the first year.

Payman: Wow.

Prav: So was this more about your sort of hand skills than the academic, although that’s needed, right, and you’re not going to get through if you don’t have an academic background. Was it assessed on that?

Kunal: We’ve all got our skills, we all know it, right? Language isn’t my best. I can barely speak English to you right now! But I was really good with my manual dexterity. So me and my cousin, we sort of worked together, and literally we only got through this working together. So I was very good at drilling. So during our exams, he’ll slide me over his tooth, I’ll drill mine and I’ll drill his. Whereas he was very good at languages. So during the language exams, he’ll help me.

Kunal: Me and him, neither one of us would deny it, we sort of blagged our way through university. The five of us graduated out of 150 people. It was tough. But I was still a bit of an angry little young kid for about two years until something changed. I met a new group of friends out there. I got a lot more responsibility because I had to learn how to use a washing machine, dishwasher, pay rent, find a new rent. I had to learn all these things, and I was the older cousin, so I had to look after my younger brother, right?

Payman: Would you recommend it to someone to go abroad to study dentistry? What about the Czech Republic, as a place to be, outside of the actual trying to get through the course?

Kunal: So Charles University, that’s the university’s name, it’s well-known. It’s affiliated to America. So it’s a very good university. Would I recommend it? When I went, and I ended up in this little village, we were the first year that did dentistry. So at the end of the five years, I did medicine with dentistry. So my actual initials at the end is MUDR, which is a medical dentist doctor. So I didn’t actually do much dentistry. It’s something that I always say: I graduated having done a couple of fillings and a handful of extractions. I had no clinical skills whatsoever, but I had loads of textbook knowledge. So these universities are amazing in knowledge.

Payman: How did you feel on your first day of seeing patients? Was it scary?

Kunal: Yeah. We had to speak Czech.

Payman: No, I mean real patients in England.

Kunal: Oh, in England? I was so lucky. Obviously, as we spoke about, I had many relatives that were dentists, right?

Payman: Of course.

Kunal: Very successful relatives who had many clinics, but nobody wanted to touch me. So I was very lucky. At that time, my brother’s wife, she was on a dental nursing course, and she was friends with this girl who worked at a dental clinic down the road from us. So my sister-in-law asked her, said, “Can you please ask your boss if they’ll give Kunal a job?” The guy went in, he was a Patel as well, and he said, “No, I don’t want another Patel.” She begged him and said, “Please, please, just give him an interview.” So I walked in. It was down the road. Met the guy. He fell in love with me for some reason. I will never forget this guy, [Jignesh] Patel. He was the guy that held my hand. No-one else would give me a chance. He held my hand [crosstalk]

Payman: Good guy, Jignesh.

Kunal: … and he let me learn from him. He was an old school dentist, proper old school. He taught me to use a paperclip as a post. [inaudible] dentistry. I was always good with my hands and all these things, so I caught up quite quickly. I have to admit, I’m a self-taught dentist. I haven’t done many courses, I never did. I just learnt as I went along. I’m one of them.

Payman: Well you did do some courses afterwards, right? So that’s the thing.

Kunal: Yeah. Well, I’ve only done one course, the Mini Smile Makeover course!

Payman: So then how long were you associate for before you thought, “I’m going to start my own practise”?

Kunal: So four years I worked as an associate, but I always wanted a clinic. Obviously my dad was on my case, like, “Your cousin owns 50 clinics. What are you doing? Hurry up, buy some clinics, boy.” “God, how am I going to get 50 clinics?”

Kunal: I always [inaudible] down. We always said that I’m never going to achieve what my cousins achieve. That was a fact. But I was always a very different-minded person. I went abroad. I came back a new person. My friends that knew me before I went out couldn’t believe the person I was when I returned. I was calm. I realised a lot in life. I had to get beaten up a few times out there by some tall skinheads. It put some sense into me. Came back and-

Payman: Would you say the Czech Republic was more of a racist country than U.K.?

Kunal: Yeah. Especially this town. So where I was in this town, they’d never seen a brown person, and the only brown people they’d seen were Romanian gipsies which were the thieves, they classified them as at the time. I was a short, brown boy, spiky hair. I fitted that model quite well. So we’ll get onto a bus and people will leave. It was only by the end of the five years when they actually accepted us, when it was time for us to leave, when they knew that we were actually bringing a lot of money into the town and we were helping.

Kunal: It took time, but when we went there there was nothing much for us to do. We had a cinema and a bowling alley. In the first year, the bowling alley got shut down.

Payman: Sorry to interrupt, Kunal, but for those who don’t know about your cousin, who’s your cousin?

Kunal: Chirag Patel, and he owns Perfect Smile.

Payman: 50 practises, or whatever.

Kunal: Yeah.

Payman: So go ahead, go ahead. Your dad was saying, “Your cousin’s got 50 practises. When are you opening yours?”

Kunal: “You need to buy some.” [inaudible] was a different place. He was 10 years older than me. [crosstalk]

Payman: Yeah. So, go ahead. That thinking when you were thinking about buying a practise, what were you-

Kunal: Yeah. So I wanted something close because I’ve always been a family guy. I’d been away for so long, I just wanted to be at home. I wanted to be back home, so I didn’t want a clinic far away. I looked for a clinic close by, for something that I could grow in.

Kunal: Being a local boy in the area, for four years I knew what people were wanting, but being an associate, I couldn’t change my principal in such a way. I changed him in many ways, and we still are very good friends, but I couldn’t because he was content. He was content with what he had. He was happy. He had a great family. He had a nice home. He was happy-go-lucky whereas I’ve always been a bit more of an ambitious guy.

Kunal: So a clinic came up for sale close by and it was on the same road as his clinic where I was an associate. So I had that difficult conversation when I spoke to him. I said, “Look, there’s a clinic that’s come available.” I managed to fend my cousin off from buying it and begged, “Please don’t buy it.”

Payman: Is that true?

Kunal: Yeah. 100%. I went for the viewing and as I was leaving… no, as me and my mom arrived, my cousin was leaving that viewing.

Payman: Oh, dear.

Kunal: So he was nice enough to let me have the clinic. So I had the conversation, I said, “Look, it’s down the road. I would love to buy it. How do you feel?” If he’d said, “No,” I wasn’t going to buy it. He goes to me, “Look, Kunal, if you don’t buy it, someone else will. So if this is what you want, go for it.” He goes, “I would love if it wasn’t you that bought it because I know your vision, I know what you’re capable of.” Because I was his biggest grosser and I was working part-time. Once my cousin did find out I was making a lot of money for Jignesh, he did offer me a job and I did take it. So I was working part-time at one of his clinics at the same time.

Kunal: And then-

Payman: Would you say you learnt from your cousin?

Kunal: Yeah. So the clinic I was working at for him, I was more or less running for him, because they have many clinics, they have managers. I learnt business. I was given an opportunity to run a clinic which wasn’t mine, right?

Payman: Yeah.

Kunal: I saw the difficulties of management, staffing. I was there, and because I had that invested, because it was my cousin’s clinic, if something went wrong, I was treating it like my own, right?

Payman: Yeah.

Kunal: So it was the best experience I could receive. So I had one guy who was like a mentor to me, taught me everything that I didn’t get from university, and how the NHS worked. Obviously I had no idea. But what was different for me is, what I found when I got to know more dentists in the U.K., is that dentists in the U.K. had more of a fear of dentistry, which was drilled into them possibly from university. I didn’t.

Payman: No.

Kunal: We weren’t taught fear. So when people say to me, “Kunal, how are you doing root canals in the week?” In my first year I did X number of crown preps. I just didn’t have any fear in me at the time. Maybe it was stupid of me or whatever, but, touch wood, nothing came of it. One of the teachings I do when I have young dentists and other colleagues come to speak to me-

Prav: To speak to your old self?

Kunal: Yeah. I say, “Look, guys, just have confidence. Don’t be worried so much.” It’s the worst thing I’m seeing in dentistry, is the confidence isn’t there, and that’s what I really feel, is… All the questions I get from dentists, they’re second guessing themselves and my heart says, “Yeah, that’s right. What you’re thinking is right. Go ahead.”

Payman: [inaudible]

Kunal: It’s that, because I feel as if we could have achieved so much in the U.K. as dentists. America, we say, is five years ahead. I think our confidence has held us back here.

Prav: You mentioned something earlier, which was you were a big grosser for Jignesh and that’s why your cousin wanted you to come on board. What does that mean and what do you think it is in you? Is it conversations with the patients? Is it being able to treatment plan? Is it being able to communicate with these patients in a way that perhaps you know what they want? Call it sales, a lot of people say it’s a dirty word. But what is it that made you a big grosser, and can you put some numbers to that?

Kunal: Yeah. So it took me a while to realise this and I think it was Payman that actually drilled it into me, and over the months of me speaking he said, “Kunal, there’s something that you’re not getting at. There’s something in you that makes you this salesman.” I have to say, it comes down to my parents, right?

Prav: Mm-hmm (affirmative).

Kunal: My dad was a shopkeeper. He worked like a donkey his whole life. I thought working is normal. I thought working 10 days a week is a normal thing. I remember as a kid, one day I was in his shop, and some lady came in and she starts talking to my dad, telling my dad about her grandkids, et cetera, et cetera, like the whole best buddies. She ended up buying not just a newspaper but biscuits, milk, everything else as well, and she left. I said to my dad, “What was her name?” My dad goes, “I’ve no idea.” I go, “What, have you never met her before?” He goes, “No. It’s the first time I met her.”

Kunal: But what I learnt from him was how he was so able to just open someone up, relate to them, smile, and just be confident enough, and I think I brought that into my dentistry, the way that he just adapts to every single person. Anyone that walks into my clinic, I will adapt my way to a way of speaking to them. My nurses get really annoyed with me because for some reason I put accents on, right?

Payman: Mm-hmm (affirmative).

Kunal: I don’t know what I’m doing.

Prav: Hi five, bro!

Kunal: I put accents on!

Payman: We get the same from Prav and from [Kailesh] saying exactly the same the thing. Because they grew up in a shop themselves, they just mirror whoever they’re in front of.

Kunal: 100%. Kailesh, Prav, I’ve got to know them. I would say we have similar personalities where, Payman, you have chucked us into rooms with people, and we’ve ended up having to speak to them. But it is a quality that a shopkeeper, I think, gives us, as a parent.

Kunal: My mom gave me a different side of life. She was a housewife. A builder came to do an extension on our house. One morning I wake up and my mom’s telling the builder what to do. I was like, “What the hell’s going on here?” I’m like, “Mom, he knows what he’s doing.” She’s telling him to put the steel 10 inches higher to get the ceiling to… I’m like, “What the hell’s going on here?” Then, next thing I know, this guy’s made my mom a partner in his building company. Three, four years later, she’s the owner of that building company.

Prav: Wow.

Kunal: I was like, “What the hell? From housewife to this. No education based on building work or anything.” I think what I got from her is that anything’s possible, right? Anything.

Kunal: I grew up with builders. My mom’s builders were Polish. We were lucky enough to have a large house, and they lived with us for quite a well. Growing up, I thought I was half-Polish! So that’s why Czech wasn’t so bad for me because it was fairly similar. But I’ve grown up with building work around me, and, being dentists, we are builders, right? I keep saying I’m a self-taught dentist, but a lot of it came down to mechanics of what we did. So growing up around that.

Kunal: So what made me the guy I am was, I think, my dad’s personality traits to adapt, my mom’s personality traits that anything is possible. Anything. And just be confident and do it. I think that’s how I got Love Teeth to where it was.

Payman: Tell us about Love Teeth. When you bought it it was called what?

Kunal: North Cheam Dental Practise.

Payman: I think I came soon after that to see you, didn’t I?

Kunal: Yeah. So-

Payman: What was the previous owners… well, it doesn’t really matter. But the previous guy was there. Prav, the outgoing principal was still there, and Kunal had put the shocking pink around, not as much as at the end, but he’d started, you’d started, hadn’t you?

Kunal: Yeah.

Payman: How did the word Love Teeth come in? It’s quite a cool name.

Kunal: Yeah. So first the name. Obviously my cousin’s clinic was called Perfect Smile and [inaudible] that name. I knew I needed a new name but it was very… We kept going back to something related to Perfect Smile, Perfect Smile. So we just needed something completely different because we needed it. I think it was my dad actually came up with it, which is weird [crosstalk]

Payman: Oh, really?

Kunal: My dad doesn’t get involved much in much we do in life, but I have to give him that. He came up with that name. I also made it very, very bright, shocking… I call it slightly pink. Because on this road where I was buying this clinic, there was 10 other dental clinics and I needed to stand out. It was the day of Only Way is Essex, it was back in them days, 2014. So I just went, “You know what? Let’s just do it.” I went shocking pink. My landlord at the time, which was the ex-principal-

Payman: Principal.

Kunal: … he went mad. I remember the nurse coming to me, saying, “He’s having conversations with your patients that maybe you are a bit homosexual, whatever.” I was like, “Look, don’t worry. It’s fine.”

Payman: Really?

Kunal: I was like, “It’s fine. I don’t care what they’re saying.” Oh, there’s my [Oculus 00:28:26]!

Payman: Oh, his Oculus has arrived.

Kunal: So I went for that. I wanted to stand out, I wanted to stamp my mark down and say, “Look, we’re here, and we’re Love Teeth.” I got you in and, Payman, I have to say, there’s two main factors in dentistry that have really given me, I think, where I am today, and Love Teeth is. I think meeting you, this guy-

Payman: Really?

Kunal: … this guy that was the owner of a large whitening company, in my head-

Kunal: In my head it was… You have to understand, I didn’t know anyone. So you know when you guys all conversate and we all get together and we have these conversations about these mentors, or these inspirations, like these dentists, you talk about Mackenzies. I didn’t know any of these guys. Right? I know Binaje and these people, but I didn’t know anyone. The person, for me, you give me at the time of day. An owner of a company took his time to come see me. For me, it was a huge thing. You came down. I think it was George you came down with to my little clinic in Surri. And the way you spoke, the way you came in, and you had time for me. No one ever gave me time. Remember, I’ve now been an associate for four years. I bought my clinic. I’ve had it for about six, seven months. No one wants to know me. No one. And you came down and you just gave me that confidence I needed. That this guy gives me-

Payman: But you were never short on confidence. That advice that I gave you, I’ve given to a lot of people, but you executed on the advice. That’s the difference [inaudible 00:30:16]. I think I spoke to someone the day before and the day after and said the same thing. So it’s that execution issue. That’s what’s impressive with you. When you put your mind to it, you go ahead and do it.

Kunal: But you gave me a couple of … I remember we spoke and I said, “I want to be a centre of excellence.” And you said, “Dude, how many whitening cases has this clinic done?” I said, “Five in the last year.” And you were like, “I think I need [inaudible 00:30:47].”

Kunal: But I had a vision. I had a vision. I wanted a great brand, like a piggyback one. You had a great brand. It looked premium, and you did what it did. I remember I got Jignesh to buy it as well. And this guy, he was buying Opalescence and keeping them in the fridge and selling 10 pounds a pop and selling whitening for 150 pounds. I got him to get Enlighten, I remember as an associate. And we went on the joint … Now, I have to say that I don’t think I would be the guy I am today without meeting you, Payman. I’m not trying to jack you up or anything, but you are somebody that gave me that time, which is something that I have heard from many people that you are that loving … Depeche also, he says the same thing, that you take us under your wing. You gave us that confidence, that look after us, because you’ve been in the game awhile and you owned one. So it was very reassuring to have you here.

Payman: That’s sweet of you to say so, man.

Prav: So then, so true. A lot of people say the same thing. Payman’s generous with his time, generous as a human being as well. I remember first meeting [inaudible] I had a comedian in me. But I remember even when I started out and he didn’t even know me, and he’d invite me out to dinners, insisted on always paying, which is why I thought he was called Payman. [crosstalk] But you levitate towards these people who are either generous or just very warming. So, yeah, I can see why you’ve hung onto that buddy.

Payman: It’s about you though, not about me. Tell us about your practise. You bought it. You started … Did you immediately change it as far as the shocking pink and the-

Kunal: Yeah.

Payman: Did you think you were going to scare the patients off a little bit?

Kunal: Well, I thought … And you remember my signs were huge, right?

Payman: Yeah.

Kunal: You remember, I bought this clinic and I drove past it three times because it was overgrown in bushes. I drove past it. So first thing I did, I cut it down. I put huge sign outside saying that I’m a dental clinic and I do teeth whitening.

Payman: I remember.

Kunal: My way of thinking was, “Nobody’s not going to come because of the way we look. I’m either going to have still no patients, but the only result I could get is get some positive.” Right?

Payman: Yeah.

Kunal: I’m not going to lose patients because of the way I look, because the clinic was doing rubbish as it was. So it was one of them factors.

Payman: Have you heard of Paddi Lund?

Kunal: Paddi Lund? No.

Payman: It’s this Australian dental group and his outlook is the exact opposite of yours. His idea is no sign at all and a locked door so no one can walk in. He wants every single patient from a word of mouth referral. Of course there’s different ways of doing business. Don’t get me wrong. McDonald’s has a sign and then an open door. But it’s really interesting though because you say the obvious thing, the simple thing of, “I want people to see me.” and so many dental practises, you go by and you can’t even tell they’re a dental practise. It’s an obvious thing.

Kunal: I’ll tell you what it is that, why I did it. And if you look at my logo, it’s very old and simple. I just looked at McDonald’s, Sainsbury’s, Tesco. And you’ve done the same thing with Enlightened, right? It’s plain, simple to read. And that’s what we did. We didn’t get fancy. And then my team … Love Teeth’s known for its team. But again, my inspiration for that was how Apple, Google looked after their staff, but also how, Pay, you looked after your store at Enlighten. That’s something that I’d never seen before. Your girls were so loyal to Enlightened and the way you looked after them. You cared about their social side of things, as well as keeping them upbeat, not just drilling down and not just being [inaudible 00:35:17]. I’m pretty sure you treat them very well, and salary wise as well. But you realise, and something that I caught on really well was, his staff love him. They care for that company. That’s something that I really put into Love Teeth. And I think that’s part of the success that I got. And that’s why when I go back to it and I say, “Payman, you were very influential on what I did,” it was these mannerisms that you have as well. It was a combination of all that.

Payman: What did you achieve with … it’s 75% or more than that NHS to start with.

Kunal: So yeah, we were 85% NHS.

Payman: Did you go in thinking you’re going to do what you’re going to do? From the outset, you knew what you were going to do, or did it evolve as an idea?

Kunal: I was lucky because you know the two clinics I worked at, Depeche’s and my cousin Sharon’s, right?

Payman: Yeah.

Kunal: They were 90% NHS fashion clinics. And I went in there and I was doing a load of private. And I remember it was the most that my cousin’s clinic has ever grossed ever, even since I’ve left. They’ve never grossed that much. They never have been back. And I didn’t do anything hard. So I wasn’t doing anything special. I was just talking to the patient. I was listening to what they was saying, and I’m just giving it to them.

Payman: It’s interesting. Did what you find comes naturally to you is that, but to lots of people that doesn’t come naturally. You’re telling me, “Oh, be good to your team.” I didn’t say, “I want to be a multimillionaire so I’m going to be good to my team.” It just came naturally to me to be good to my team. It wasn’t something I did. So that’s what I’m saying. You and Kailash, for instance, but you’ve got this idea that you listen to your patient, give them what they want. A lot of dentists don’t have that in their head. A lot of dentists don’t.

Kunal: I mean, look, I don’t have any ego that … As I keep saying, I’m not a UK grad. I don’t have like a university year full of geniuses that are teeth models and all this fancy stuff running courses. For me, if my quality of work isn’t liked by other dentists, it doesn’t phase me. I know for example, Depeche, he won’t share something unless if it’s 100% fantastic in his mind. In my mind, his work, even something that’s rubbish to Depeche, he’s amazing. But in his mind he wouldn’t do it because that’s the way … For me, I’m not bothered if another dentist doesn’t like my work, as long as my patient does. For me it’s that patient, that’s it. And I’ll guess Kailash is the same, right?

Payman: Yeah. He’s focused on the obvious. Kailash recently does want the profession to acknowledge him as well as the way I noticed the way he’s talking. But let’s carry on. It was 85% NHS?

Kunal: Yeah.

Payman: What happened?

Kunal: And then I piggybacked on Enlighten. I piggybacked on Invisalign. I made options very simple for my patients. And within three years we had quadruple turnover. So, the clinic was valued at what, 350K when I bought it?

Payman: Yeah.

Kunal: I got it valued last month, post COVID, and it’s been valued at 3.5 mil.

Payman: Whoa.

Kunal: 10 times.

Payman: Amazing, wow.

Kunal: And then post COVID. And again, the one thing that I keep saying is I’m not doing anything special. All we’re doing is listening, looking after our team and our patients.

Payman: You’re doing something special, right? Because what’s now the split NHS to private?

Kunal: We are 95% private.

Payman: In three years?

Kunal: No, it’s been six now.

Payman: Is it six years?

Kunal: Yeah, it’s been [inaudible 00:39:14].

Payman: Your Invisalign numbers, break it down, man.

Kunal: So you recognised me quite early on, right?

Payman: Yeah.

Kunal: But no one else had still heard of me until one year I decided I was … I was being FastBraces, that other American … And I was a senior master of [inaudible] of them, which meant that I was doing the most in the UK. And it wasn’t hard. I always knew about Invisalign, but I was always piggybacking off my cousin’s account because he had big discount. So when I set up my own clinic, I didn’t have that discount. And being a dentist, like we all are, we want to go for the lowest [inaudible 00:00:39:58]. So I was doing FastBraces. And then I sat down and I realised … actually one of the reps, Aaron Bernard, came up to me from Invisalign and he’s like, “I need to speak to you.” He saw my big FastBraces sign outside, domes in and he goes, “Why are you doing FastBraces, Kunal?” I was like, “This is cheaper.” And he goes, “How much chair time do you use?” I was using about 13 hours chair time per case in total, 13. And he goes, “With Invisalign, we can get that chair time down. Your biggest expense is this, that …”

Kunal: Anyway, so he made sense. And I said, “Well, I’m only going to do it if I get cheaper [inaudible 00:40:34]. I want the biggest discount.” And he goes, “You have to do X amount of cases in a year to get that.” I went, “Well, the only way I’m turning to Invisalign is if I get that discount by the end of this year.” And then that’s when iTterra had just come out. I hadn’t seen it. I didn’t know about it. He just said, “There’s this machine that will simulate teeth and show your patient’s straight teeth before they even start.”

Kunal: So I thought in my head, “No. The only way I’m going to achieve this target and get to this discount level and make this possible for me is if I hit 150 plus cases.” So I bought an iTerra. And I still remember, I went and bought it. I went to look at head office. We bought it, it came back. It was the biggest thing of my life. I was spending 25 grand on this machine. I remember me and my wife, Lucy, went out for dinner to celebrate it on the way home. And within three months I ended up buying another three.

Kunal: At that point, my wife, Lucy, probably wanted to divorce me. She thought, “What the hell are you doing?” But I saw what that technology was doing. We were showing people teeth straight before they even invested the money and time into it. So I just knew that this was it. And this is what I based my whole business model. And 40% of our income now comes from Invisalign.

Payman: I thought it was even more than that, man.

Kunal: Yeah, so did I, and then I realised I was doing quite a lot of crown work like Hamish. I didn’t say how much of that percentage was Enlighten.

Payman: About the Wedding Smiles. How did that happen? First of all, explain what that is.

Kunal: So, Wedding Smiles came from the success of bringing the iTerra into the clinic. I just saw patients, heads explode. Even my nurses’ heads exploded when they saw the simulation, the technology that was available. And because the clinic was doing so well with it, I thought, “I want to take this to the public. I want more patients.” And we decided we’ll brand it with your help. Payman, I think you came up with the name Wedding Smiles, didn’t you?

Payman: No, no, no. I didn’t like it, remember. I came up with the idea. You were going to go there and call it Love Teeth.

Kunal: That’s it.

Payman: I said, “Don’t build a stand, build a brand.” Do you remember?

Kunal: Yeah.

Payman: And then you said Wedding Smiles. I said, “No, that’s too obvious.” I had the Bright Smile in my head. They were my biggest competitor when we started. And I was saying, “Bride Smile.” And you were saying, “That’s just the bright. I went straighten everyone’s teeth, not just the bride.”

Kunal: Yeah. And you know what? The idea was we’ll go to a wedding show and we’ll take whitening and Invisalign directly to patients. [inaudible] consumer American-type model but dentist-led. But I had inspiration from your stand at the dental shows because you have the best stand the dental shows. Your stand is amazing. And I thought, “If I’m going to this wedding show and I’m taking my staff out of the clinic …”

Payman: Totally right.

Kunal: So part of me doing this was a social event for my staff, the team, to get them out of the clinic, because I knew I wasn’t going to make millions doing this, but I wanted to do it because we had this idea. So I created a stand like your Enlighten stand. I came to you and I said, “I want your stand.” And you went, “It’s not cheap.” And I went, [crosstalk 00:44:13]. But we did it and we had the best looking stand in the whole place.

Payman: Yeah, you did.

Kunal: It was a three-day thing. And I think it was a lesson though, because what we did at first was we gave everyone Enlighten toothpaste if they came and got a teeth scan done, the whitening toothpaste from Enlighten. And I remember you guys … and this is why I love you so much, Payman, I couldn’t sell Enlighten whitening at this thing, I could just give away free toothpaste, which you gave me. But also you get me money for the actual stand as well with nothing in return. These people I’ve had in my life influence, my mom, my dad, you, it’s being the way you are so generously. Everyone says it now, “Kunal, you’re stupid generous with your information you give out to people.” And I’m just like, “Look, it’s everyone’s worm, right? Everyone could go out, try their own.” It just makes … it cheers me on, actually, the more competition I have. I love it. Ready Smiles happened, straight teeth, four months.

Payman: So how often do you do that?

Kunal: We did it twice a year until pandemic hit. Look, there was some years … wedding shows are very difficult, or exhibitions are. It’s all dependent on time of the year, the weather, and position in the venue. So it’s a very expensive trial and error thing.

Payman: Yeah, trade fairs are tough generally, dude. But you couldn’t have done all of this volume of work without loads of marketing, right?

Kunal: Yeah.

Payman: What were you doing? What were we doing? I know Kraft’s taking care of your marketing now, but what were you doing before?

Kunal: So, Prav, when did you come on? You came on about six months ago, right?

Prav: Something like that.

Kunal: And I have to say, wow. I’ll go to that in a second.

Payman: But you were doing something before Kraft came along.

Kunal: [crosstalk] So, I’ve loved computers at a young age. I was locked in Czech Republic and all we had was a laptop. So I was always very good with computers. So very early on, I figured out a way to do my AdWords myself and do all these things myself, AdWords myself. Everything that everyone sees from Love Teeth that came out was me. I did then get some help from another colleague in the industry who helped me out for awhile. And the reason why I’ve tried to keep it to myself is I did get ripped off years ago. Some guy from … I think it was from Leeds. I don’t know if I should name him, but he made me a website for like six grand, which is a huge amount of money. This is back in 2014 or something.

Kunal: And it was terrible. And it was fleecing me as so much money on marketing because he knew … he thought I didn’t know. And I knew what was going on. So when I called him up on it, he just gave me all the rights to my website and ran. I called him out because he was saying that he was spending X amount of money on words and this and that. But he didn’t realise I’d know, because I used to do it myself. So then for a long time, I just did it myself, Love Teeth, the whole branding. I’ve made errors. I owned a billboard in my local area, which I don’t know if ever brings me any patients in, but my point was brand awareness. I saw McDonald’s everywhere. I just wanted brand awareness. If people didn’t know what Love Teeth was about, I just shoved it everywhere. That was my reasoning behind my marketing.

Payman: When did you first meet Lucy?

Kunal: I think we should get her into … So, Lucy, she came in … I was about six months in Love Teeth. I just bought Love Teeth, about six to nine months in. She actually saw my FastBraces sign as well. So look at that! Invisalign came knocking, my wife came knocking. So it’s clear, signage works. She was a dental nurse at another clinic. She comes in and takes me to that next level in life.

Payman: What happened? What was the event? How did you first meet?

Kunal: She came for a job interview.

Payman: Talk us through that interview, buddy.

Kunal: I’m now a practise owner. I’m not an associate in life. I’m searching for a dental nurse. Lucy walks in.

Payman: In the clinic?

Kunal: Yeah. For an entry … I’m actually late for my interview.

Payman: Standard.

Kunal: Yeah, at that time, because I was working at another location. I was still working at Depeche’s. I used to own an RA back then, back in the day. And she’s already in the building, I rock up in my RA, get out. So she hasn’t even seen my car yet. [crosstalk] It was funny because my mate was visiting and he was a final year dental student. And he goes, “Can I sit in this interview?” I’m like, “Yeah, sure.” He goes, “Can I ask the questions?” I’m like, “Yeah, sure.”

Kunal: So we both walk in. Lucy’s sitting in reception and we invite her into the surgery to do an interview. So Lucy sat there, it’s me, and my mate. Remember, my mate was all about asking the questions. He wants to get some experience under his belt. I look at him, the guy’s not saying a thing. I’m like, “What are you doing?” Something I need to say is that Lucy is an absolute stunner. I didn’t even know what to say. So I’ve got to interview this girl and all that’s going through my head is …

Kunal: Get out, don’t do it. Get out, don’t do it. Don’t fall in love. Don’t fall in love. What I’m thinking is, “Don’t fall in love with this girl. Be professional. Ask her the questions.” So I’m asking her the questions and I’m all over the place. My mate is still door to the ground. He’s still not saying a single thing. And we’ve asked her and I’ve said, “How long have you been around? How long you been working at your place?” Whatever. And I go, “Oh, I know that clinic.” And she’s like, “Oh, how do you know?” And I went, “Oh, I know them from the area.” She turns around and gives me, “But you’ve only had your clinic for six months. You don’t know them really, do you?” And I was like, “Shit.” I knew straight away this girl was smart. She was smart. She was beautiful. She was calling me out on my rubbish that I was talking at the time. I was trying to be a biggie two shoes, “I’m a clinic owner, come and work for me. Leave the guy who you worked with for X number of years.”

Kunal: She called me out, turned around, and she left. I sat down with my mate and said, “Mate, what happened?” He goes, “I don’t know. I don’t know. I don’t know. I didn’t know what to ask.” What the hell? I was like, “I’m screwed, aren’t I?” And he goes, “I agree because she was a stunner.” And then I managed to convince her to come work for us, but we had to set my mind straight, nothing more was going to happen. She was just going to work for me. But that changed quite early on as well. I loved how bright she was. She was you unreal. She was a single mom and she was the type of girl that I was attracted to. I got to know her. She was a strong lady, determined. One thing I was always missing in life.

Kunal: And I kept saying this to you guys, and I said it right at the beginning of this podcast, I didn’t have many friends. And I would try and stop fights and things to try and make myself popular to them by defending people in life. And then I was abroad, I came back, there aren’t many friends, no one really knew who I was. I walk into a bar, I’m small. Oftentime, I remember in bars, it’s a proper confidence knocker for me. I don’t get served. You know there’s that bar at the bottom of the bar, when you want to get … I have to stand on it to try and get served.

Prav: Know the feeling, mate.

Kunal: [crosstalk] trying to throw my money at the bar, man, and hold it out there and then show her that I’ve got Platinum Amex. I wouldn’t get served. And it knocked my confidence in years that I was that guy. Even though my dad gave me confidence, the only thing that gave me confidence to talk to people in public was my dentistry. Up to me becoming a dentist, I never had a job in my life. I would be that guy that will go buy something from a shop, and the person the shop will be like, “Hi, how are you? Are you good? Are you good today?” My answer would always be limited, look down, “Bye, yeah. Thanks, bye.” It’s only once I became a dentist and I realised I was maybe good at what I did, I’ve got confidence in that.

Kunal: So I’m still not confident in public, but I was confident with my patient. Meeting Lucy changed it. I knew that these taller blokes than me, when I walk into a meeting or whatever I’ve got, I’ve got a hot wife, right? I did not give a crap. She gave me a [crosstalk] cup of confidence that, “Okay, there’s something maybe about me.” No joke, some of my best friends right now, I’ve met them many times. They didn’t know who I was or remembered me. They started remembering me because I was the brown guy with a hot white wife. No joke. We were that couple.

Payman: Kunal, talk me through … You’ve you’ve obviously talked about Lucy and the confidence she gave you and everything. Just talk us through step-by-step, very quickly. She starts working with you, for you. She’s your nurse at that time. At what point did you go on your first date? At what point after that were you an item? And what was the transition to getting married? And then, you being in your own words, a typical traditional Brown boy, how did that go down?

Kunal: So obviously this girl has come to me, she’s a stunner and she’s my dental nurse. Very early on in the first couple of days, I realised she’s got a child. Right. So in my head … remember, this is me back then, not my way of thinking, probably ignorant or whatever else. I thought, “Okay, fine. She’s got a kid. I’m not going to get with her. Safe. I’m safe.” I wouldn’t do it. So she’s my nurse. After a week of nursing with her and getting to know her, I take her down to the pub and on the way … and I remember, and she’s going to hate me for saying this. I took her down to the pub for lunch and on the drive back, she was like … She’s going to kill me. She was like, “So, how do you know I like you,” or something like that. I was just proper arrogant and just said to her, “You’re going to be mine,” or something like that. You’re going to be my-

Payman: One week one. One week.

Kunal: She knows the exact words because she always cringes about it. I’ll let her tell you. But I learned early on that this was a woman I’ve always wanted, a powerful woman. And she’s got a child so she can look after a family, and I’m a family guy. And she was family and she was smart and she was pretty. So it was like, “Damn, what am I going to do?” But when I started getting feelings, I realised she couldn’t be my nurse. And she was very smart and I always want to bring aesthetics to my clinic. So there was a company called 3D Lipo. We brought that into our clinic and she was good with people. So she started taking over that side of the business, aesthetics. So while we were dating, she wasn’t nursing for me, but she was running a different side of the business for me, and she was more of a free spirit. I thought that was very important for our relationship, it was going to grow. But obviously she’s still got a kid. Now I’m like, “What am I going to do?”

Payman: Can I just ask a quick question, mate? At this point in your relationship, was she just a girlfriend or did you realise that it was going to be more than that?

Kunal: She should refuse to be my girlfriend. I kept trying to make her my girlfriend at that time. I was like, “Come on, let’s go out,” or whatever else. And she was like, “No,” because she has to be careful because she has a daughter. She didn’t want to just be dating anyone. And then one day I met this daughter and that’s when everything changed for me. She was the most incredible young lady I’ve ever met. She was eight at the time, the most loving, caring, most polite child I’ve ever met. And I’ve got a lot of nieces and nephews. They don’t talk to me this politely in my life. This child, she was … And I was just like, “Wow, Lucy knows how to raise a kid as well.”

Kunal: So then the next thing, I thought, “Okay, this is the girl I want to marry. This is the girl I want to be with.” So then, being a traditional Indian boy, I hid it from my parents.

Payman: For how long?

Kunal: For about six to seven months. And then my parents started realising that I-

Kunal: And then my parents started realising that I’m not coming [inaudible 00:00:05]. Right? And my sister-in-law, I remember I said she was a dentist, right. So she started working at my clinic. So she knew Lucy very well. So then my parents started a note thing that I was obviously seeing someone and they didn’t know who. And My parents had met Lucy working at the clinic. They got to know her. They built that relationship. And [inaudible] more or less just went and told my mom, “Okay, now, I’m seeing this girl. It’s Lucy.”

Payman: Being traditional Indian boy, what did they think about someone who’s not Indian and has a kid? Did they have challenge?

Kunal: Yeah. Unfortunately, it will. And I was now 30. And in the Indian culture, that’s quite old to not be married.

Payman: Is it? Is that right?

Kunal: Yeah. So my brother and sister got married at 23, 24.

Payman: Bloody hell.

Kunal: And they knew the type of guy I was, I wanted to get married when I was 18, 19.

Payman: Why?

Kunal: I always wanted to get married and have kids.

Payman: Why?

Kunal: I’ve always been that guy, probably because I was abroad so much in life.

Payman: You want to belong to something?

Kunal: Yeah, I wanted that. Right? So from a young age, I always wanted to get married. I was always a family, traditional, Indian guy, but I was very westernised because I lived in Czech Republic for six years. So I think they knew that I wasn’t going to settle down like a normal, Indian, traditional boy does. So I think at that point, they just wanted me to be happy. And they’d been through a lot of things in their lives.

Payman: What about on her side? Or maybe we should ask her?

Kunal: Yeah. I think maybe you should ask what her parents actually thought about us.

Payman: Is she coming in?

Kunal: Yeah. Should I get her in?

Prav: Just quickly, in that six months or so that you were hiding it from your folks, what was going through your mind? If somebody didn’t grass you up, so to speak, did you and Lucy have conversations about this? These difficult conversations, she wanted to meet your parents, she wanted to be a part of your life, she wanted to get her daughter integrated into your life? What was going on there in the relationship?

Kunal: So obviously she had to be very, very careful in terms of it wasn’t just her that she was bringing into the relationship, it was her daughter. So she always had to be careful. And she was always being very strong about looking after Kira and making sure she’s shielded from aspects. So we used to have the conversation. She got to know my family as patients, as owners.

Prav: From a distance.

Kunal: Yeah, from a distance. So she knew they were really nice, a good family I came from. And she had a child quite young so she missed quite a lot of growing up. And her decision making wasn’t the best in normal social life, but Kira was spot on. But general decision-making in life, so I used to help her out quite a lot in an unbiased way and making correct decisions about life and things like that. So she knew that I was someone that she could trust in a way.

Kunal: So it then got to the point where I knew I wanted it. I had the conversation with her and said, “Look, the difficulty is going to be Kira. Right?” But my parents found out, she knew, and then we just thought, rather than us sneaking around… Even my parents said, “Look, if this is the goal you want, then bring her to meet us.” And obviously she was a bit fearful. She had always met them, but not as my girlfriend. And I’ve always said that I’ve never taken a girl home. They’ve never met girlfriends of mine. Because the way that I was, the only girl that was ever going to bring home was the girl I was going to marry. So obviously she knew how important it was, but we knew it was always going to be dependent on Kira, on if we were going to work or not. So I brought her home. My parents met her for the first time. We made it very casual, not like bring the girlfriend home, it was a cas thing, last minute. Mum was making homemade pizza. And I get a message from my sister-in-law who knew that [inaudible] at the time saying, “Just come around. Bring her home. Come and bring her home for dinner.” Last minute thing, I said, “Lucy, you’re coming home.”

Kunal: She’d go, “No, no.” Brought her home and she fit right in. She wasn’t someone that was scared of the culture or fearful, because what I found about Lucy was she hadn’t been exposed to many things. So to her, it was exciting. It was a family. It was a lot of love that was there. And then we decided quite early on that they would move in with us, which is unheard for in Indian culture.

Prav: Mom and dad moved in with you guys?

Kunal: No.

Payman: Lucy and Kira.

Prav: Oh, Lucy and Kira, sorry, sorry.

Kunal: Move into our family home.

Prav: Pre-marriage?

Kunal: Pre-marriage. If it was going to work, we needed to make sure, which is unheard of. So we kept it very quiet from the rest of the family, as in relatives. And they moved in and it just really worked. It was the best decision we made. We had to be sure for both sides of the family, if Lucy would adapt to the culture that we bring. We’re not the most religious people in the world. You know, I just do the fun events most. We do Christmas massive as well. So we’re not the strictest Hindus in the world, but we have a bit of culture in us, the food, our mannerisms can. So she came in and they adapted very quickly. As I said, Kira was a very polite kid. And I promise you now, I think Kira made the whole thing possible, because the way she was so loving to my parents, out of nowhere…

Kunal: We’ve got nieces and nephews, my niece, my dad’s been begging her to give her a hug for the last eight years. Whereas Kira was in there hugging my dad likes, being really grateful. There was a kid that was grateful at the age of eight. It’s unheard for. And I kept trying to stop it from saying thank you. But she was, and it was unheard for. And I think that’s what made it possible, and my parents obviously needed to adapt that. And it was strange for them, but they realised it’s my life, my future. They’re not going to be around forever. And then my mom said it, “You make your decision, just know that you’re going to live with your decision. Okay? We’ll be there. As long as you’re happy. And that’s it.” And that’s where we were.

Payman: How was it living together for Lucy, living with her in-laws and all that? I can understand it with an Indian [inaudible 00:07:11]. But with an Indian woman, she expects that a little bit. A little bit, although many aren’t living with their in-laws, are they? But for someone who wasn’t ever expecting to do that, to then go and do that, it’s a big step, isn’t it?

Kunal: Yeah. So Lucy had been quite an independent girl from a young age. She had Kira. She’s got great, fantastic parents, but they weren’t like my Indian parents were, which are quite strict. Do this, do that. They let her do her thing in life. So coming into an Indian culture, I did say that mum is quite influential in our house. She’s like the queen. And coming into the house, we knew it’s not easy for anyone, no matter what culture you are. And before Lucy, obviously being Indian and being at an age of 30, I was introduced to many Indian girls for marriage. And the one thing that they would all be saying, the majority would be like, “I’m not staying with my in-laws.”

Payman: Really? Even the Indian ones?

Kunal: Yeah, yep. It’s this normal now. And I’m not saying all, but it was very common. They don’t cook Indian food, don’t speak much [inaudible 01:06:31]…

Payman: But then if that’s the case, you could move out now if you wanted to, but you just don’t want to.

Kunal: Yeah. As I’ve always said, I’m very family orientated. And the Indian culture tends to be, if you’ve got two boys, one of you stay with the parents and the other one moves out. It’s normally the younger one that moves out, but my brother and my mum’s personality is very similar. So they clashed a bit more than what me and my mum do. And I was the younger one. So I stayed, and he was older. So they went out, I’ve stayed. And I always said from day one, any girl that was meeting is, “Look, I’d love to stay at home first when we got married. Just because there’s so many qualities my mum has that I’d love my wife to have for my kids’ sake in the future.” I’m not saying I won’t move out, but the house is bloody huge.

Kunal: You can live on one side of the house, mum and dad can live on the other, and you’ll never see each other, if it was a problem. But I have to give Lucy a lot of credit. Payman, you were at my wedding, weren’t you?

Payman: I was.

Kunal: And she surprised us all by singing a Hindi song at my wedding. She was on it to learn the language, she was motivated. And this was before she got really busy, but she was showing these signs. And she really has been trying and still is, but there’s always going to be difficulties with two strong headed women in one house. No girl, I don’t think, wants to not be queen of their home, but Lucy is smart enough. And she’s so happy go lucky in that sense. She’s cool, we all know. And she says that my mum offers her so much. And she’s got so much respect for my mum, because just seeing how powerful and strong she is, that she’s learned a lot. I’m not saying we will never move out, but for now, it’s working. And we’ve got a young baby, so built-in babysitter. Woo-hoo! The best thing that comes with in-laws is having babysitter constantly.

Payman: Tell us about this in during lockdown, you were on TV a lot. How did that happen?

Kunal: My claim to fame, right?

Payman: How did that happen?

Kunal: Okay. So it must have been my social media presence. So I was casted to be the face of NHS Dentistry.

Payman: Oh, yeah.

Kunal: So as a dentist, that’s as close as anyone could find us. So the BBC contacted us through social media and said, “Would you like to be interviewed?” And it was literally the day before. And then next morning, I’m being interviewed on BBC breakfast.

Payman: How did it feel? Because you called me, you said, “What should I say?” How did you actually feel just before you go on national TV?

Kunal: Yeah. So I was lucky enough to have the opportunity with yourself and in Invisalign to do a bit of public speaking. So it wasn’t my first time public speaking. But it was my first time, obviously, national TV and that sort of thing.

Payman: What was going through your head? Were you saying, “I’d better not mess this up.”

Kunal: Look, it was difficult time. Those of you who know my personality, I believe in energy a lot. I want to be upbeat, positive. I didn’t want to become negative. And obviously Facebook was blowing up at that time in our forums, a lot of negativity from dentists. I made the mistake by asking the question on a forum before I went live, “Look, I’m going on, BBC. Is there anything that you guys want me to cover?”

Payman: Yeah, I remember that.

Kunal: Dear lord, I couldn’t believe. It was great to see dentistry street came together, but it was so much negativity. And the story at me at that present moment in time, it was about Nightingale, and how as an industry, or dental NHS, we were making ourselves available. II didn’t call BBC to come and interview me. They came because they knew that we had made ourselves available. So that was all the interview was about. But dentists were hammering me about, “Talk about your finances and how we’re not getting help.”

Payman: Which if you remember, do you remember we spoke that night? And I thought your approach was absolutely right. And this thing about us going on the BBC during a global pandemic and talking about us was such a huge mistake. And what you ended up saying, I thought was the exact right thing to say, saying, “Listen, we want to donate PPE. And we want to be part of the solution,” not, “Oh, we can’t make enough money to pay our bills.” Ridiculous.

Kunal: Exactly. And I did that interview and what I wanted to show, which was… Again thanks, Pay, because you made me stick to my guns. And my guns were, the whole population is in a bad way right now. They need the positivity. They needed to feel as if all of the NHS were grouping together to help the world, or the UK, right? Not us complaining about whatever it was.

Kunal: So after that interview, I went back onto Facebook and I went to see what the outcome was now. 99% fantastic. Everyone said, “Great, Kunal. Your energy was great.” Some people made the comment of smiley dentist. I don’t know if they’ll try and take the mick out of me or what, I didn’t care. But it was what I went to do. I wanted to show the nation, give them some hope that there was positivity. But then I’ve got them people that were saying, “Oh, why don’t you talk about this? Oh, you’re smiling there. You weren’t talking about the right issues.” You know, again, me quite a bit of stick. And it got me down. And then I was invited to next morning to have to speak on BBC News.

Payman: The day after?

Kunal: The day after. I had to go on again. And this time, I was like, “Now my head’s all over the place.” Now I was in a bad place because I’ve got some negativity, I’ve got close friends, which was very surprising to me. I’m not going to mention any, but I’ve got some close friends that were trying to make me push the agenda of the finances, which really upset me. And I start thinking, “Why are you guys making me… You’re my mates, right?”

Payman: But it was a funny time. Some people thought that was the right thing to talk about.

Kunal: Yeah. I get that.

Payman: It’s not like they were trying to mess you up.

Kunal: Exactly.

Payman: In my opinion, they were wrong, and you were right. But that’s the reason they did it.

Kunal: Yeah, no, a hundred percent. And I do feel that. It was a very stressful time. But obviously at the time, I was all over the place. And there were people that I looked up to that were, I felt, misleading me down the wrong line. And so my second interview, I wasn’t so much myself, I felt. I felt I was trying to push the agenda and it wasn’t what I wanted to say and what the public needed to hear. I was pushing an [crosstalk 01:14:02].

Payman: Do you regret it now?

Kunal: My second one, yeah. Yeah, I do because…

Payman: What did you say? I can’t remember, tell me. What happened in the second one?

Kunal: It was more about trying to push the views that we shouldn’t be closed in the first place, all of this. And it was the wrong time. And I didn’t need to say it. I regret it because it wasn’t my fight to fight. We had people that should have been fighting our corner. And it wasn’t for me being there, and BBC didn’t want that story from me. BBC wanted..

Payman: Listen, man. At the time, I remember on the radio that the British Association of Pharmacy, whatever, had bought ads. Ads, actual adverts saying, “If you’re not careful, your pharmacist won’t be around at the end of all of this.” The Independent Pharmacy Association. And buddy, as you’re all going through a pandemic, do you think anyone cared that the poor old pharmacies might not be there anymore? People were worried for their own lives, their own jobs. So I think your messaging was correct, dude. And I think you should understand why people were saying what they were saying because it was a weird time. This hasn’t happened in a hundred years.

Kunal: No, a hundred percent. I get it. It was a difficult time. I remember. Can you remember? I think it was us three. We had a phone call one morning.

Payman: Oh, we did. Yeah.

Kunal: We did. And I’ve never been like this in my life, but Lucy came down, and I was on the sofa. And I was just crying. And she goes, “What’s wrong?” I go, “The way I dealt with life pre pandemic, as a dentist, we’re untouchable. We’re always going to have an income.” And I was spending money like, no, man. Those of you know me, I don’t want to be successful alone. I share wealth. I want to be wealthy with people because it’s more fun, not alone. So when I sat down and I was asking my cousin to borrow some money because I said to all my staff I’ll pay them a hundred percent wages. And I was sat there and I was like, “What have I done in my life? How am I in this situation?” But then I spoke with you guys and we weren’t alone. We were all…

Payman: I cried, buddy. I cried. And I remember having a FaceTime call with you and you had to hang up, mate, because I think you were getting a little bit emotional. And that’s all right, mate.

Kunal: But you know what, again, I went on the BBC, because the second interview, they didn’t want to invite me back straight away, I remember. Because I pushed it. And then the story started changing. I went on the radio, then the story started changing. Then it wasn’t so much about we needed help and support, then it was about the NHS. Dentists not opening. So then they got me back on, and then it was good. But then at this stage, it was weird because, remember, Lucy’s a nurse, traditionally. She was a nurse, she’s now a practise manager or whatever else. But she was a nurse. So she’s part of the nursing forum. So when I went online and I said, “It’s safe to go back. We should be allowed to go back. We’ve got the PPE. We should be open,” I got a battering on the nurses forums, proper abuse.

Kunal: Okay. And Lucy’s part of them and she’s reading it. Now, all I learned to be thick-skinned, and I did prep my family beforehand. I said, “Not everyone’s going to like what I say,” especially after my first interview. I said to my parents, I said, “However, majority will, whoever will. We just look at the positive. Don’t read the negative. Don’t care. I’m not bothered. You guys don’t get bothered.” So there was a lot of [inaudible] to me. And it was the fact that we were trying to get nurses to go back to work. Let’s be honest. Right? And maybe majority of them were getting a good deal, 80% furlough, sit at home, whatever else. But I was trying to get that message. And she got really upset. And she…

Payman: She got upset. She’s quite defensive about you.

Kunal: [crosstalk 01:18:18].

Payman: I’ve noticed that when there’s a social media backlash, she comes on it.

Kunal: Oh, she comes. This nurse, she is my Rottweiler. I’ve said I used to have a temper, I’ve got rid of that thing, but wow. This girl can fight my corner.

Payman: But you should bring her on. We should bring her on, man.

Kunal: Yeah. Sure. I’ll grab her. I’ll be right back.

Payman: Yeah. If she’s around, bring her on. Hello.

Lucy: Second round to the marriage counselling, is it? Hi.

Payman: How are you?

Prav: He’s been saying nothing but amazing things about you, Lucy.

Kunal: Yeah. I was at that point where…

Lucy: He’s hungry.

Prav: You know what, guys, what, what stood out for me around that time… Lucy, we were just talking about the time when Kunal was on TV. And people were just sort of having a pop at him. And I remember a comment from Lucy, which was along the lines of, don’t quote me on the exact words, “My husband is not a string puppet.” Yeah? “He’s gone out, he’s done this, he’s done that.” And I thought, “My God, what a woman.”

Lucy: I actually had so many inboxes from people who were saying, “You’re such an inspiration. I’m so glad that you said it. And I wish my wife would have done the same.” And I thought, “Oh, I didn’t realise.” But it was true. People were giving him so much advice, or they were wanting him to say so many things. And it got to the point where I think I did just say it quite simply, at one point, I just said, “Well, do it yourselves. He’s the only one putting his neck out right now, so why wouldn’t you do it? If you’ve got so much to say, then do it yourselves at the end of it.” But he did really well.

Kunal: I was really grateful. But the conversation I did have with them was that by doing what I was doing, I was going to leave myself exposed to this. And I decided to tell BBC… Who came? MyTV and Sky came after. And then I decided, no. Because I could see that every time I would go on, my family were more nervous than me. Seriously, they were so nervous for me. And I thought, “I’ve had a bit of exposure, right? I’ve said what I’ve said. I don’t want to put my family through this.” So we decided to stop. And then that’s when I passed it on to [inaudible 00:01:20:39]. We passed the details of [inaudible 01:20:41].

Payman: So Lucy, tell us, you’re such a big part of Love Teeth. Let’s take it all the way from the social media presence to the hiring and retention of staff and the way you talk to patients and all that. But let’s go back to that first day when you met Kunal. What did you think?

Lucy: I thought he was really cocky.

Payman: Is that what you thought?

Prav: How was the interview?

Lucy: The interview, I had never been in an interview like that before because he brought his, I didn’t realise it was his friend, I just assumed it was another dentist, with him. I was sitting in the waiting area and I was actually interviewing the patients. And I was saying, “How long have you been going to the practise? What’s the vibe that you get?” And I was actually interviewing a couple that had only just recently joined since the new refurb. And they were saying the dentists are really, really nice. So that’s what I wanted to know, was the relationship that I could be entering into myself. I came from a private-only practise where you would… It seems strange past COVID now, but I would have to go downstairs, say by their name or if there were over a certain age, it would be by their surname.

Lucy: Mrs. Smith, for example. And I would have to shake them by hand with eye contact and a smile. Now, obviously all that element is completely gone, hasn’t it? But that’s just what I used to have to do. So I had a completely different vibe when I came to Love Teeth, because I didn’t really know about the whole NHS side of it. But I did come from the non-affluent area that obviously Love Teeth is established in. And I just wanted to bring something different because I think Kunal had taken it so far, but I knew that there was so much more potential that could have come. So anyway, he’s late for the interview. So already for me, I’m thinking, “Who does this chap think he is?” And two chaps walk in, himself and his friend. And I don’t know why, I just assumed the taller one at the time was probably Dr. Patel.

Kunal: See, this is why my confidence is so bad. This is why I needed her.

Lucy: And this thing with spiky hair and a Gucci belt followed afterwards and I just thought, “Ugh.”

Kunal: She still says that every morning.

Lucy: I still say it every morning. And then we went in for this interview and he stood. And he stood and he had his foot up against the wall. He was leaning against the wall, with his shoe up against the wall. Very confident. I’ve never seen anything like that before. And he had my CV in his hand. And he goes, “Oh, right. So what practise have you come from?” And I said, “I’ve come from this practise.” I said, “It does say on my CV, which is in your hand.” And he looks at it, “Oh, yeah, yeah, yeah.” [crosstalk] piece of paper, trying to act very sophisticated. And he goes, “Oh, of course. Because we’ve had quite a few patients come from your practise.” I’m like, “Oh, it can’t be that many because you’ve only been here for five months.” And then I think he just sort of realised, “Okay, the interview is not necessarily going to go the way that he thought it would.” And it just sort of went from there, hasn’t it?

Kunal: See, that’s when I realised she was smart.

Lucy: I’ve always been quite quick on my feet. I don’t know why, but I’ve always been like that.

Prav: Lucy, what were your impressions walking away from that interview in terms of like, did you think, “I really want to work there now?” Or what was going through your mind as you stepped out of the door?

Lucy: I turned the job down.

Kunal: Oh, dear. Here we go.

Payman: Oh, really?

Lucy: I’ve still got the emails as proof.

Kunal: Oh, dear.

Prav: He missed those details out earlier on.

Payman: Yeah, he didn’t mention that.

Lucy: Oh, of course. It was so romantic. I was like, “Can I start now?” No, no, no. It really wasn’t.

Prav: Fill us in.

Lucy: So I was leaving the practise that I was working for, literally because it was very full on, I don’t want to say too much, but it was very full-on. It was very intense in the place that I was working. And I think it was starting to impact my mental health and also my home life as well. Obviously, I’ve got Kira, my amazing Kira, but I was that mum that wasn’t always there at nativities. I was the mum that maybe if I came to the parents meeting, I was only there very, very short and I needed to go back to the practise. And that was just because work became my life, and I needed that work to be able to support Kira. But it you how it does, it spirals out of control. And I’d always lived in the area. I knew North Cheam Dental very well. It was a local spot where I lived. And then I did see the signage changed. And I remember driving past and thinking, “Wow, that practise looks amazing. It looks so different now. I can’t believe it.” And then a couple of weeks later, this vacancy popped up on Facebook. And Kunal likes to call it the saucy pink, it was very pink. And I said, “Oh my goodness, that’s that…”

Prav: It’s like your t-shirt, practically

Lucy: Yeah.

Payman: Yeah. Cheers, mate.

Lucy: Even brighter.

Payman: That’s all I’m feeling today, mate. So I always put a t-shirt on to match my mood.

Lucy: Love Teeth. And I couldn’t believe it. I just thought, “How funny is that?” That they’re now obviously looking for someone. And I remember emailing in and just saying, “Look, I’m really sorry. I actually don’t have a CV, but I have experience in this, that, and the other.” And they said, “Yeah, come coming for a job interview.” And I just quickly drew something up on that CV that he obviously never looked at anyway. And yeah, we just went from that. But I think one of the things that I’d like to think that I brought to Love Teeth because of that is team care. I think all practises, I think a lot have focused on patient care, the patient journey, the patient experience, patient, patient, patient. But how can you look after somebody if you’re not being looked after yourself? So…

Lucy: … if you’re not being looked after yourself. So you are only as good as your team are and as long as you look after them, and one of my biggest and proudest achievements is that I’m now a team faculty speaker for Invisalign. So, I’m one of the first non-dentists, or dental hygienists, or therapists, but I stand up and I get to represent the team members and I think that’s so important everyone [crosstalk 01:27:24]-

Payman: So Lucy, what would you say is your biggest tip regarding team happiness?

Kunal: She feeds them.

Lucy: Number one, I know it sounds daft, I am, I’m a feeder, but-

Payman: You get them lunch, surprise lunch or whatever?

Lucy: Literally one of the stuff literally said the other day, “Oh my goodness. Lucy always brings the best snacks,” but for me, you can bring in donuts, you can bring in pastries and cakes, or get them a Nando’s But I like to always take it to the next level, in the terms of, I’ve got girls that are gluten free, I have the vegans, I have everyone and I make sure I cater for all of them and they never have to tell me twice.

Lucy: It’s the fact of they know Lucy knows. Sometimes McDonald’s will just arrive at the practise and Kunal will say, “When did you take everyone’s orders?” Wasn’t it, one of the girls said, “No, Lucy knows what we like.” I think it’s just those little … I know it sounds really daft but-

Payman: No it’s not, it’s not, it’s really important.

Prav: Huge.

Lucy: Little details of just people knowing Lucy’s going to look after and even food, or just being that listened.

Kunal: So I don’t think she even realises when she does it.

Lucy: No I don’t it.

Kunal: For example, those are cold going around or something. Next thing we knew, I walk into the kitchen at work. There’s 10 packs of Berocca, there’s like a pharmacy there, for all of the team to take. I’m like, “Love, you know how expensive this stuff is?”

Lucy: But your team are valuable.

Payman: [crosstalk] remedy expensive.

Kunal: Expensive, man.

Payman: You bastard.

Lucy: They’re worth it.

Prav: Do you know what you just said there Lucy is that, as somebody who has a restricted diet or whatever, whether you’re vegetarian, vegan, or something like that, there’s actually nothing more embarrassing or awkward than being handed out some food-

Lucy: That you have to turn away.

Prav: … in front of everyone else that you can’t eat. Then you’ve got to say, “Well, I’m a vegetarian,” or, “I don’t eat carbs.” It’s embarrassing. So that’s huge, that’s absolutely huge.

Lucy: Really? I just like-

Prav: Huge.

Lucy: I just like to cater [crosstalk 01:29:31]-

Payman: Who’s the good cop and who’s the bad cop out of you two in the practise?

Lucy: Oh, that is so a tricky one.

Kunal: So you know what we’ve tried to do? Do you guys ever watched that TV show, Billion?

Payman: Billiard. Billions, billions.

Kunal: Billions.

Payman: I’ve seen one episode.

Kunal: Right, so they have a member of the team, which is for HR or whatever, just wellbeing, mental wellbeing of their team. Someone to talk to, someone that will encourage, motivate them, push them harder. So what we’ve tried to do in our clinic is I’m the boss, they know Lucy is the boss as well, but also I’m the boss that will be nice, smiley, whatever but when you’re out line, you will know. So, I’m known to make my staff cry, but not because I’m mean to them, but just because in a way, they get to feel that they’ve let me down, right?

Lucy: Yeah, that’s exactly it, they’re more devastated.

Kunal: That they’ve let me down, that’s why they’ll cry. So there’s a comment around at the clinic, “Oh, you’re going to have a meeting with Kunal, you’re going to end up crying.” But what we’ve done is Lucy is that person for them to go talk to for their own mental wellbeing and all of that. So, that’s what Lucy’s there. Obviously she brings a lot more, she’s our concierge service, but she she’s there for the team in that manner because we’ve got girls that live in this country alone, from all over the world and they live alone and they go through their own issues. We found out quite early on that if they’re not doing well outside of work, they’re not going to do well inside of work.

Kunal: There’s 24 hours in a day, they spending about nine and a half to 10 hours of that day in the clinic, eight hours sleeping. So how much free time are they getting outside? There isn’t. The saying that we always say is, this is your safe place. This is your place of happiness. Outside of here is where the problems are, so this is your escape. Then that’s where Lucy comes in and that’s her role. She does it very well. She’s always there to comfort everyone and I think Payman, you’ve got that in your place, the dynamics between Sanj and you, the way it is with your staff.

Payman: Yeah, yeah, definitely.

Kunal: And I think it’s very important. I think what we find is the teams that are doing really well in the businesses have this sort of dynamic. So that’s what Lucy really brings is that nurturing, caring, they feel safe.

Payman: What’s in the future for you guys. So do you want to make this brand more like a regional, national, what do you want to do? Do you want to just keep that one gold, jewel in the crown and do other things in business?

Lucy: Yeah.

Kunal: Tell them.

Payman: Oh hello.

Lucy: We’re like Pinky and the Brain. We wake up and say, “What’s the plan today?” And he goes, “Take over the world.” I remember when he was working at [inaudible 01:32:35], I’m sure’s been mentioned. I said to him, because I was working full time at Love Teeth and he was working part time when we first got together, actually. I said, “You need to be here.” I said, “Your presence needs to be felt.”

Kunal: But I wouldn’t leave.

Lucy: He couldn’t because of the loyalty and I completely got that. I completely got that.

Kunal: Well, when I bought Love Teeth and he allowed me, I said to him, “I’m only going to leave when you ask me to leave, because you gave me the hand in life.” My mom always said, “Whoever gaves you that first, you don’t.” So even to this day. So, I never left. He was keeping me on for like one day a week or something like that. Until he had to let go but then … yeah, carry on Lucy.

Lucy: Yeah. Then I said, “Your presence does need to be felt.” I knew that somebody just needed to say it. I think he knew in his heart, but sometimes you just need someone just to say when things aren’t right. Eventually he did slip to Love Teeth full time. Naturally, we’ve got [Chirag By 00:06:42] to compare to, who’s got so many connects. I think Kunal wanted to go straight into that and I said, “No.” I said, “Let’s make one super clinic.” I said, “We’ll probably end up being able to make something in comparison to that just by having the one.” I think we’ve done just that and I think now it’s time. Yeah, I think we can execute it. The problem always is, when you go to Gordon Ramsey restaurant, you don’t expect him to be the one frying things for you it’s just, you’re trying to make it replicable. It’s quite hard, there’s not always going to be a Kunal and there’s not always going to be a Lucy in HR but the whole point is that I think if we look after the people that we have now, we can definitely replicate that. I think as long as we have a presence every so often in other places … but yeah, it’s taking over the world now.

Payman: So what is the answer to the question? What are you going to …

Kunal: So we will [crosstalk 01:34:43]. So we’re purchasing at the moment, two clinics.

Payman: Are you, are you, are you, are you, are you?

Lucy: Yep, nothing by halves. Never do anything by halves.

Kunal: So there’s one more, which is an existing dental clinic, which should be coming through soon and we’re going to have brand it Love Teeth and just do it again. The current Love Teeth in North Cheam will be the flagship that will be our main hub and then everything else will be like a franchise model. So, as we grow, we’ll bring on partners. The partners’ focus will be to do the clinical and keep the standards high and with myself and hopefully Prav on board, we will create a franchise model where we can market these clinics and with a Love Teeth brand. But we’re going to try on these two first, one’s a squat, one’s an existing.

Payman: Nice.

Kunal: We’ll take it from there.

Payman: And where are they? Are they all in Surrey?

Kunal: Yeah. So I’m not going to central. It’s not my cup of tea and that’s where my cousin has all these clinics.

Payman: No, but if someone said, “Look, I’m in Edinburgh and I want to open Love Teeth in Edinburgh.”

Kunal: Yeah, we’ll do it.

Payman: As a partner, you’d do it right?

Kunal: Yeah because through Invisalign and things like that, we’ve worked with other clinics and all three of us here know, or all four of us. We know the hardest thing in any business is staffing. The fact that it’s so inconsistent, we’re dealing with humans. So one thing I’ve worked on is we have to make things simple when it comes to a business model. Love Teeth’s business model is very, very simple. It does take a bit of training and I’ve got the … people like you two, the guys who I think train the best. I mean, Pay, don’t you still do webinars every week for whitening? And Prav, I’ve seen your webinars and they’re inspirational.

Payman: So mate you’ve got this chance, you’ve got the chance. Here you are on national podcast, you guys tell me, what is the USP of Love Teeth in a sentence?

Kunal: Experience. So the aim is to have a modern day experience. No matter if it’s to get your teeth done, or any part of any business, the only way we’re going to survive going forward in this future, which is going to be taken over by machinery, technology, digital, anything that’s repetitive is going to be taken over. So only thing that’s going to keep us to survive is our own uniqueness, the human side of it, is an experience. So, experience.

Lucy: I think experience, but also confidence. Having that confidence to just go for it and just determination. I mean, when you look at Kunal’s life, he could have had it really easy, in a way. He didn’t probably need to graft as hard as he has. Even sounds crazy to just say, but having having Keira so young, I could have just got a council house, we live in the UK. That’s what it could have been but we’re two very, very determined people and we just want to bring out the better in every single one of our individuals that come through our clinic. Whether it’s training the staff, but also for the patients as well, we want them to be the best versions that they can be. I think if you read our reviews, everything comes down to the experience and the friendliness. Friendliness, believe it or not does come down to confidence in a way, because if you’re not confident, it’s very hard to come across as friendly. Because if you’re shy, you can come across as very rude without realising, completely unintentionally.

Lucy: So to have that friendly manner, that confidence to be able to talk to people, the confidence to be able to speak about Enlighten in depth, speak about Invisalign in depth. We train them in every aspect, isn’t it? But was that confidence, that brings the experience.

Payman: So just imagine this guy in Edinburgh said, “I want to be love teeth.” How much work do you reckon you’d have to do on the team before you felt like, I’m happy to put the logo up there and they’re going to be Love Teeth? Isn’t something you need to work out, isn’t it?

Kunal: Oh yeah, 100%, there’s logistics that we’ve been going through. So also the next thing that we’re doing is we’re creating our own course.

Payman: Are you?

Kunal: And this course is going to be based on the webinars we’ve done together, but we’re going to go out there and we’re going to fill up courses on individual delegates and then we’re going to give the opportunity for teams to come to our clinic. This is Lucy’s idea, which I think you might have been part of in the past Pay, where you’ve said that this is a great idea, where people come to our clinic for a day with their entire team and they will see how a flow will work. So it will be on a weekend, they pay an X amount. They’ll come in and we’ll go through reception, concierge, TCO, the dentists, the whole flow of how it is. We’ll train this team up and then if they want to be part of a franchise model, a startup, they can go ahead and do it. But we’re not in that position right now if someone says, “I want to open one in Edinburgh,” right now.

Payman: I mean, this is probably how you’ll end up meeting those people, so you’re absolutely right.

Kunal: Yeah, exactly.

Payman: You’re absolutely right.

Kunal: That’s the way we’re going to be doing it because they need to see what we’re about. What I do with Love Teeth isn’t everyone’s cup of tea, right?

Payman: No, no, that’s right, that’s right. But the secret sauce, that secret sauce that is Love Teeth, I’m sure you’re going to get enough people wanting to experience that. Robbie’s the same, isn’t it?

Kunal: Yeah.

Payman: He’s got people want to go to Dental Excellence and see what is it about Dental Excellence. People want to be in that building to see what that patient experience is. I think it’s going to be similar with you guys.

Kunal: I mean, I think it was … The one thing I must say, what Lucy changed for me in being a principal owner is she made me see things as a dental nurse-

Lucy: As a team member.

Kunal: … how life can be difficult with a young family. So it made me like … We really look after our staff now, proper. We really look after them because I was able to relate that to what Lucy’s [inaudible] could have been, or et cetera. But also she gave me the aspect of what a patient sees when they walk in, so every time we go to a hotel or a restaurant or anything, Payman, you always said that first thing in our first meeting about that burger analogy that you have. We look at these things now, whatever we go, and we want that five star experience for our patients. No waiting, cleanliness, smell, everything is [crosstalk 01:41:38].

Payman: You guys should listen to the Zubair podcast, because he doesn’t talk about this, this stuff that you’re doing, this is your USB here. He talks about how to manage a big group and he set it up from the second one onwards. He started putting systems in place because he wanted a hundred eventually. I think he’s on number 10 now. Have listened to that, that’s a goodie, a goodie.

Kunal: Definitely, so it’ll be my second podcast after your two’s interview.

Payman: It’s been so nice to have you guys on, man. This is the longest one we’ve ever done.

Kunal: Sorry.

Lucy: [crosstalk 00:15:13].

Prav: He rattles on a bit, but what I really want to just touch upon very quickly and we could go on for much, much longer guys is just home life and family life. What’s Kunal like as a dad to Keira?

Lucy: Oh my goodness. I will say, it would have never continued, the relationship would never have continued if it wasn’t for the fact that he is amazing. In fact, I would almost put it out-

Kunal: [crosstalk 01:42:41].

Lucy: … that’s actually better with Keira than he is [Kyan] in a way. He’s really close to Keira, they get along so well and she thinks so highly of him. Believe it or not, he helped her with her studies so that he got her into this high school.

Kunal: I flew back, didn’t I?

Lucy: Yeah, he flew back from, what was it?

Kunal: Copenhagen.

Lucy: Copenhagen when she had her her 11 plus exams.

Kunal: She wanted me to do [crosstalk 01:43:06].

Lucy: Honestly, he really cares for her and I think that’s so important. One little story about Keira, just to explain her as a person and their relationship, as well is he once … The first Christmas he spent with her, he got her a cardboard box and it was just to toy around with her, just to tease her, because he’s used to having nieces and nephews. He wrapped this cardboard box up in wrapping paper, and she opens it up and it’s empty. He goes, “Oh, Keira.” As you do, “Keira, I’m so sorry. It’s been really hard at the moment. We haven’t been able to see many patients. We haven’t got any money at the moment.” She goes, “That’s okay.” She goes, “I can do so many things with this box.”

Prav: Oh, dear.

Payman: Oh, that’s so lovely, what a lovely girl.

Lucy: And it really humbled him, I think [crosstalk 01:43:56].

Payman: What a lovely, lovely girl. So I got to say from my side, the two of you, Kunal and Prav, when you say, “My daughter, my son,” and Prav’s got two step kids, it really, really makes you feel like you really believe that. That you feel like the father of those kids, both of you. I’ve really noticed that.

Prav: Yeah and I’ll speak from my voice as well, it’s not the easiest thing in the world and I know that, but deep down inside, you’ve got these innocent, young, little human beings who look up to you with a degree of respect and as a source of inspiration, or as a role model, or whatever that is, and you put some love back into them and you’ll get 10 times back out.

Kunal: Because in a way, we are making ourselves a bit more vulnerable to her at some point in the future. So there’s going to be a time where there’s another dad and we put so much love in, and we are making ourselves vulnerable but they’re worth it, you know? That’s what I mean. Who’s going to walk her down the aisle? I’m already thinking about that. Is she going to let it be both of us, is it going to be-

Prav: Listen.

Payman: She can decide, let her decide, we’ll [crosstalk 01:45:14].

Kunal: And I have no quarrels, I know there’s going to be a heartache in the future, but she’s worth it, that’s what I say.

Prav: Yeah, and you just got to rest assured buddy, whether you walk her down the aisle, he walks down the aisle, you insist there’s going to be two father of the bride speeches and you make sure yours is the best one, buddy.

Kunal: You’re going to be writing my speech for me, bruv. No, what else am I like at home? That’s all right, I’m a good dad.

Lucy: No he is, he is a good [crosstalk 01:45:49].

Kunal: I’m not a good husband, I’m a good dad.

Prav: What’s the dynamic like at home Lucy, in terms of living with extended parents and that side of things? Obviously it’s not traditionally the culture you’ve been brought up in.

Lucy: Oh definitely not. I mean, what a support network. I was a lone wolf, really when I came and I now have a pack. I think actually living in a joint family, I think that is one of the things that changed me as an individual. I think I’ve become more caring because of it. I think, when one of our girls became ill and she couldn’t leave the house, and I just found myself outside her front door with a bag full of medicine and oranges and food.

Kunal: She had COVID, didn’t it?

Lucy: She had COVID and yeah, she was by herself. She’s a young girl by herself and then before I knew it, I just … obviously I couldn’t go in, but I was doing these things. I was thinking … you know you drive away afterwards and you think yourself, “I just did that.” And I did it without even-

Prav: Thinking.

Lucy: … thinking. Yeah, I think having that joint family, that love, that constant love and that support. I mean, don’t get me wrong. It’s not always the easiest. I’d find it hard living with my own mum now.

Payman: How did your parents take it Lucy, when you said, “I want to marry this Indian guy?”

Kunal: It wasn’t your mom it was your nan, wasn’t it?

Lucy: Yeah, we faced a bit of … I mean, what you don’t understand is that the part of Surrey that we live in, I think I had one Sri Lankan guy in my whole school, there wasn’t … and I just knew that he was really good at maths, that was it, so I didn’t really know. When I first met Kunal, I went away from that job interview not knowing that he’s thinking, “Oh yeah, she’s nice.” I just thought, “He’s married with kids.” I’d never really met Indian people before. It’s a very white area and we faced a bit of stick. It was quite difficult on the flip side. I know it was obviously very difficult for Kunal as well but I think it just made us really strong. I don’t think there’s many things that can hit us. Obviously we have our blips, but generally, we’ve been through so much in such a short period of time. I mean, five and a half years, how quickly does that go? But I don’t think there’s … I think we’re pretty much unstoppable. The only things that can stop us are each other.

Kunal: And my health.

Lucy: And his health, if he doesn’t look after his cholesterol.

Prav: We’re going to sort that out, Lucy.

Lucy: Yeah, hopefully.

Payman: Don’t worry, the Oculus is coming.

Kunal: We’ve missed the delivery. Guys, I was mid-

Lucy: I got this text, “Lucy, it’s come.”

Kunal: I was in mid conversation with you, the Amazon driver’s outside. No one’s answering the gate, he’s driven off with my Oculus.

Payman: Oh no, you’re kidding.

Lucy: I’m going to have to chase him.

Payman: You’re kidding.

Prav: Jeez.

Payman: Well, it’s been wonderful. I’ve really enjoyed it very, very much. It’s nice Lucy, to have him on his own saying the things that then you come back and actually confirm what he said and with a few nuances thrown in. Really nice to have you both on.

Prav: We’re going to end with my final question, Kunal. So you know what this is?

Payman: No, he doesn’t listen to the podcast, dude.

Prav: Okay. So buddy, just picture this. I just want you to think about this, all right? You’ve got your 50 practises now. They’ve all got the Love Teeth logo of them, in every city. You’ve made it. You’ve fulfilled all your dreams. You’re doing very little dentistry, but unfortunately the time’s come to live your last day on the planet. You’ve got Keira and Kyan next to you.

Kunal: Is she there?

Prav: She’s there.

Lucy: I’m cooking.

Prav: And you’ve got to leave them with three pieces of advice. Then I’ve got one more question after you answer this.

Kunal: Look after each other.

Lucy: Just go for it, I reckon that would be your-

Kunal: Be confident in life and don’t take shit from no one.

Prav: Nice, man. How would you like to be remembered? Your legacy? What would you like people to say about you?

Kunal: I am doing all this hard work because I want to leave a legacy for Kyan and Keira. How do I want to be remembered? Like a positive, hardworking dad that made a difference in one way or another. That’s why I’m doing, honestly, I don’t really care about much of … I said it earlier, I don’t really care how people take me, but I want to not let my kids down. So I want to leave them with a positive remembrance about me. Who can say, “Your dad was cool.”

Prav: Lucy, if the shoe was on the foot and it was Kunal, Keira and Kyan? Tell me about your three pieces of wisdom that you’d leave the world with and how you’d like to remembered.

Lucy: I think I’d like to just always be remembered that I was always there for everything. Anything that the kids had ever gone through, I think that’s the best thing that Kunal’s let me always be there for the kids, and him, and the people at work, and the family.

Kunal: Three.

Lucy: Three bits of advice. Just go for it, 100%. Just go for it. For my kids, just get those grades. I know it sounds daft, but that sets you up in life and just keep smiling, smile through everything in life.

Prav: Beautiful, thanks guys.

Payman: Thank you.

Prav: Thank you so much.

Payman: This has been brilliant. Thank you so, so much.

Kunal: Thank you guys for taking up Sunday-

Prav: It was really good.

Kunal: … and doing it on a Sunday for me. I know-

Prav: Absolute pleasure mate. Absolute pleasure.

Outro Voice: 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.

Prav: 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 guests has had to say, because I’m assuming you got some value out of it.

Payman: 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.

Prav: And don’t forget our six star rating.

There’s no love like brotherly love. And there’s plenty on tap in this week’s episode, as we welcome Kailesh Solanki, brother of podcast host Prav.

Kailesh talks about his journey from growing up in Manchester in the shadow of his elder brother to forging his own path as one of the UK’s busiest and most prolific dentists.

Warning: As Kailesh lets us in on some of the secrets of his success, there will be expletives and maybe even some tears. 

Enjoy!

 

“I made friends with my breadman who delivered bread at the shop, and one of his really close friends was a dentist. So he said, “Why don’t you go and see my mate. He’s a dentist, he does super well, he’s got the best Mercedes in the golf club. The guy’s chilling. He does two days a week.” I was like: “Let’s have a look.” – Kailesh Solanki

In This Episode

00.51 – Backstory

15.04 – Into practice

21.32 – Kailesh’s secret

23.50 – A day in the life

28.47 – Being prolific, polymathic

36.22 – On failure, success and mentoring

47.06 – KissDental and family business

57.51 – A traumatic experience

01.06.08 – Future plans

01.10.41 – Efficiency hacks

01.16.53 – The dream

01.30.42 – Advice for the next generation

About Kailesh Solanki

Kailesh Solanki graduated from Manchester University in 2003 and went on to gain implantology qualifications.

 

In 2005, Kailesh purchased a practice in central Manchester which he rebranded under the KissDental moniker and quickly expanded the clinic to a group of three.  

Kailesh: In the next five to 10 years, that’s where I want to be. I want to be that guy that helps other people. I don’t want to retain all this knowledge and think, “Yeah. It did well for me, but screw everyone else.” I want people to say, “Do you know what? He was a top guy, and he taught me a lot. And I am where I am today because I listened and I used what he said, and I moulded it into how I wanted to do it, because that’s important.” I don’t want you to be me, I want you to be you with the tools that I teach you.

Intro Voice: 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.

Prav: So it gives me great pleasure to welcome my brother to the Dental Leaders podcast. Seems a little bit surreal that we’re going to be interviewing my younger brother who I spent most of my life growing up with. I seem him as one of the super heroes of dentistry, and often misunderstood in dentistry, but absolutely talented at what he does, both in business and clinically. But I’ll let him take the stage now. Kailesh, let’s take things back to me and you growing up as kids, what our childhood was like, what it was like growing up, and take it from there.

Kailesh: Yeah. Yeah. Obviously I was the black sheep of the family. Pravish, he’ll happily tell you, he was golden balls. Everyone loved him, my dad, my grandad, the milkman that delivered the milk every morning. Literally everyone thought the sun shined out of his ass, so I was the kid that basically wanted to emulate him. He was my hero growing up because he was super clever, and anything he put his mind to he was good at, he took sports or made all the teams, and that kind of thing. So from my point of view, growing up, I grew up in Pravish’s shadow in a way.

Kailesh: He was a year older than me, so he started high school before me, he was in pram school before me, he went into the six form before me. And everything that he then achieved, it was pressure is on really for me to push myself and ensure that… it was not like I was going to ever do as well as him. And he was just a very clever cookie in that respect, but it allowed me to want to have someone that I could look up to and push, really. And drive myself to ensure that I had focus, really.

Prav: But Kailesh, your focus was on the chicks, right? Let’s be honest, mate. I was the academic, and you was the lover.

Kailesh: Well, yeah. I mean, I’m going to be honest, he didn’t fare too well with the ladies, our kid. And I’m not saying I’m a perfect oil painting or anything, but yeah I had different dreams and aspirations as I was growing up. And I’ll give you an insight into Pravish’s day, he’d wake up, he’d have his breakfast, he’d go upstairs and study. He might come down for a bit of lunch. He’d go back upstairs and study, and then probably about 9:00, 10:00 he’d come back downstairs. We might watch a big of telly together, and then it’d be bed.

Kailesh: For me, I’d wake up, I’d probably want to play computer games. I’d want to go out with my mates, just knob about basically. Yeah. Probably chat to girls, want to be with girls, and so my focus was very much more social. My dad owned a corner shop, so I enjoyed being in there and socialising with the customers that came in, making great relationships with them people. So we had very different focuses, and although I was still reasonably academic, because I had to be, because my brother was and my dad essentially pushed us to be academic, you’ll get a treat if you know your 10s times tables, or if you don’t do your seven times tables before such a thing, you ain’t going to get this.

Kailesh: My dad was super geared to pushing us and wanting us to be clever, go to school, do well, go to college, do well, and so on. So I had to be that kid, but there was another part of me which always wanted to come out. Sometimes it was suppressed because of cultural stuff and my dad being pretty strict, and my brother like I said being this super human, literally never put a foot wrong, so I’d be the fucking guy that getting bollocked for going out and lying about it and stealing alcohol from the shop or sealing cigarettes from the shop and selling them to my mates and trying to make a quick quid. Pravish generally wouldn’t do those things. I’m not saying he never got in trouble because of course he did, but-

Payman: Do you remember when he went off to study medicine at Oxford, do you remember thinking what am I going to do and how did it come to dentistry?

Kailesh: Yeah. It was a lonely time because you can imagine my mom and dad split up when I was quite young, probably I think I was, when they finally, finally split up, probably like 10. Pravish was 11. So it was just me, my dad, and him for essentially 10 years. And then Prav decides to go all the way to Oxford to university, and for the first time it was just me and my dad. So it was really, really weird. It was really lonely. I mean, it put pressure on mine and my dad’s relationship, because Pravish was essentially the peacemaker. And then dentistry came about because I didn’t want to do what he was doing. I mean, Christ, he studied hard before university.

Kailesh: The kind of energy and effort when he put in when he was at uni and what I saw of that, I was like there is absolutely no way I ever want to do anything like that. But I knew that if I was going to go to university, and by the way during all of this my dad thought I didn’t have a brain cell in-between my ears. So he kept saying to me, “Son, it’s okay. You can work in the corner shop and then if things go well, maybe I’ll buy you another shop and you can work in that.” And I was thinking to myself, I mean, I don’t want to do what my brother’s doing, I definitely don’t want to do what my dad’s doing. And so I was like what the fuck am I going to do.

Kailesh: So I made friends with my bread man who delivered bread at the shop, and one of his really close friends was a dentist. So he said, “Why don’t you go and see my mate. He’s a dentist, he does super well, he’s got the best Mercedes in the golf club. The guy’s chilling. He does two days a week.” I was like let’s have a look. So he managed to arrange for me to go and see him and literally I just fell in love with the profession there and then, and not because this guy had a nice Mercedes or whatever. I straightaway saw that this guy was a businessman. He owned I think four dental clinics in [Wigan 00:07:29], he owned a lab. I went to his lab, I went to all his different clinics, I saw the teams that were working, I saw the nurses which obviously is always a plus.

Kailesh: And literally I was like this is a perfect thing for me. I can talk to people, I was, I’m not saying I’m massively artistic back then, but I enjoy doing stuff in my hands, and I thought I can’t go too far wrong. This is a 9:00 to 5:00 job where I can pretty much run a business, do well, and felt like it may be something I could do long turn. And in university terms, it was like a professional degree. And it also meant my dad didn’t think I was a complete fucking failure. So I thought this is actually a real good shot. I was trying to get on to this degree and be something.

Payman: That guy, who was that, do you know the name of the dentist?

Kailesh: Dennis. Oh. The dentist? The dentist, a guy called John Randall. He actually was really big with the DDU I think at one point, and the GDC, and retired due to being overweight. I mean, the guy was a unit, I mean talking 30 stone plus. I think he did actually genuinely retire in the end due to weight issues, but I actually met him at a conference probably six, seven years ago. Might be a little bit longer. And I actually went up to him and said, “Do you know what? You are the reason I took up dentistry.” We had a bit of a chat and a laugh about it, but yeah I still remember and really nice guy. Nice guy then, and when I met him 10 years ago, nice guy again.

Prav: Prior to that our kid, you were involved in business buying and selling computers, going to trade shows on the weekends, making quite a lot of money. At that time you would go maybe on a Saturday morning, go into Bowlers Trade Fair or whatever and start building computers, selling computers. Do you want to just tell us about that?

Kailesh: Yeah. So when I got to university the story was my dad, still being super strict as he is, and by the way I’ve got an amazing relationship with my dad now and we have had our ups and downs, and I’m sure like all families do, but he was very, very much study, study, study. You don’t need a job, you don’t need to work. I’ll provide you money to do those things. Not that he was flush. We owned a corner shop. We weren’t exactly the top 1% of millionaires in the country, far from it. But he used his spare money to make sure that me and Pravish could get what we could in respect to especially education. I never had a nice pair of Nike trainers, but I had the best computer at home. That was my dad.

Kailesh: And so, I got to university and literally he used to give me 10 pounds a week and that was to buy my lunch, to go out with my friends. And I was thinking, fucking hell, it doesn’t even touch the sides. If I got a sandwich a day it doesn’t even cover it. So I started trying to think about what do I know? How can I earn money and support myself for university. I’d donate during my college time, I was a treasurer of the sixth form so we ran certain stuff to ensure that the sixth form made money and I know I could do that. I’ve done bits and parts of my dad’s shop, and had little business ideas and run them through. So I got to uni and I thought because I was so into computers and stuff and I loved computers, so I started thinking well, maybe I can make some money from this.

Kailesh: So I started helping some friends. Their computer would break, I’d fix it, they’d pay me some money. And then I started building a few computers for a few people. And then I got involved with a guy who owned a little stall in The Arndale. And he said to me, “Why don’t you come with me, and we’ll do this together, and we’ll do these computer fairs. And throughout the week we’ll build all these computers, and in the weekends we’ll sell them and we’ll split the money.” That was perfect for me. He had time throughout the day, so he was doing business throughout the day. I had time in the evenings, so I do help him in the evenings.

Kailesh: And then we’d get a van each, a transit van each, fill all our stock up in the weekends. We’d go to Bowlers in Manchester, we’d go to Sheffield, Nottingham, Liverpool. And we’d go and sell these computers, and components, and hard drives, and monitors, and anything you could physically sell in respect to a computer, we did it. And we started making a killing and we got to a point where I think our initial investment was something like 1,000 pounds each, and then to the point where before we ended the business, I imagine we were spending 35 to 40k a week on stock.

Payman: [crosstalk] Bloody hell.

Kailesh: [crosstalk] But the margins weren’t big, so initially the margins were super strong. But by the time we were at 30, 40 grand a week on stock, we’d only have to have one product that would bottom out that week and we’d barely make seven or eight percent on that. So it was low margins, but I was a student. If I made three grand a week or whatever, I’d be happy as a pig in shit. So I had all the best gear, I had a nice car, I had a nice apartment in Manchester. I was chilling, because from my side, it was play money really, and it allowed me to crack on and carry on and do dentistry, which to be honest with you at that point wasn’t even something on my radar.

Kailesh: I was literally always thinking do I want to do dentistry? It got to the point in 2002 where I had to make a decision. Do I want to carry on with this computer business and take it full-time, or really knock it on the head, finish my final year in dentistry, and do teeth? And in the end I made the decision that let’s finish the degree, let’s get it done, and see where that takes me. And I said to my business partner at the time, “I need you to now take this and roll with it, because for me, I can’t be split between the two things,” because it was taking up so much of my time.

Kailesh: Year one, through university, failed both semester. Restart both semesters in the summer, luckily passed. Year two, same scenario. Year three, had 14 pass/fail [vivers] in the summer. I mean, fucking it must have been a record. I passed 13 out of 14 of them, which was great because I must have been able to fricking talk the high legs off a fricking horse, but essentially the one thing I didn’t pass I had to then resit in the summer again. So the first three years I was stressing my eyeballs out. I never luckily resat a year, but I was on that brink, and unfortunately it was because my focus was torn between different things.

Kailesh: But then year four, year five, is when I came into my own because we were doing clinical work, I enjoyed that. It was a lot more practically based, not theoretical based, and I smashed that. Won a clinical prize when I graduated, and all that kind of stuff. So it was a kind of game of two halves for me, dental school, and the first half was tricky because it was all education, and then the second half was practical, which then made me start to feel like I could do this. I could be good at this and worked it from there.

Payman: So you didn’t have a standard student life at all, but when you qualified, pretty soon after that if I remember, you got married and started your practise. Is that right?

Kailesh: Oh, yeah. Yeah. So I did have a few issues with ladies during university and the main, and it almost, it’s difficult to say scared me, but it made me feel like maybe I need to distance myself from that, and get married, and that settled me and it allowed me to focus on other things that I needed to focus on. So that’s basically what happened. So I graduated. I very quickly in 2004 got married, and in 2005 my first child. And obviously on the back of that it allowed me to really focus on work. And so, 2003 I started doing my post-graduate courses, I did the one year Paul Tipton course in pretty much everything.

Kailesh: So I signed up to his restorative, his aesthetic, his hands on, his implant course. I literally smashed every course I could do. I went abroad to do courses, I did sedation courses. I literally did Botox courses. I did everything you could physically do, just pumped any money that I had spare into doing education. And it allowed me to focus, focus, focus, to get to the point that in 2005 I was like, “Do you know what? I want my own thing now and I want to have my own clinic.” And [crosstalk] that’s where Kissdental was born, really.

Payman: [crosstalk] Had you been working somewhere else as an associate?

Kailesh: Yeah. So I did. Luckily as I graduated, and there was a couple of clinics that I wanted to be a part of in Manchester, one of the clinics had lasers, had a Cerec machine. Was just known to be a little bit more, yes NHS based, but very highly geared privately. And I didn’t want to work in, not a disrespectful way, but a poor area where all I could do is just to NHS dentistry. I always knew my view on it was to move into the private sector as soon as I could.

Kailesh: And so, this clinic was a great stepping stone for me, but it was one of those things that they chose you, you didn’t choose them back then. So I needed to make myself known there, and I did quite a few things like write them letters beforehand, went in, spoke to the reception team, tried to just literally use every physical angle I could use to get noticed. And eventually it worked and they offered me the VT position there.

Payman: So then you spent what, how long there before you decided to start your own?

Kailesh: So I did one year of VT, and that took me to like June, July, summer 2004. And then, I put the offer in for my practise the winter of 2004. So I did years VT, but I was, from my point a view, as a bit of an exceptional VT I would say. Not blowing my own trumpet, but for instance my VT trainer once, or my VT mentor who looked after the whole VT group and we had to fill out these booklets, and then in it as after month three you have to fill out what your NHS income was, and what your private income was. And so, I think that year month four or month five, my private income was something like gross figures of like 24, 25,000.

Kailesh: And he was like, “I think you’ve got this wrong. Is it two-and-a-half thousand?” And I was like, “No, no. It was 25,000. That’s what I grossed that month privately.” I said, “Obviously I don’t get that money. I was just a VT at the time.” I said, “But that’s what I did.” And he was like, “Well, it’s just not really possible Kailesh.” And I was like, “Well, no. You can speak to my trainer if you want. She’ll vouch for me.” I said, “I’m not making these figures up. It just it is what it is.” And I just had that ability, I think, right from the start to talk to patients, and talk to them about various options. To be fair, I was geared in a clinic that was like that so it allowed me to be that person. And very quickly, it dawned on me that that’s where my thought, my skillset lied really.

Prav: Well, in addition to that, bro, on the weekends you travelled to Leister or [Lufbur] was it at the time?

Kailesh: [crosstalk] Yeah, so-

Prav: [crosstalk] And do some additional private dentistry during your VT and you pretty much set records there as well, didn’t you?

Kailesh: Yeah. So I worked for a guy, funny enough, worked under his NHS number. He was a super sound guy. He was having a few issues, lost a few associates. Sanjay Vyas his name was. Honestly heart of gold, one of the best guys I’ve ever met. And I met him, I went for a job, he advertised an associate job, so I went there and then he realised I was a VT, and he almost knocked it on the head from there on in. And I said, “Come on, please. I can speak to my trainer. I’m sure she’d be happy for me to work privately under your number.” And he actually said, “Fine, let’s do it.”

Kailesh: And he took me on, and within I think three months I was his highest grossing associate he’d ever had, basically. To a point where I helped develop his business, he wouldn’t mind me saying, helped him consider other avenues of dentistry, I think, and allowed him to grow his practise in Glenfield, in Leicestershire, to another level, really. And I worked there even after VT, probably for a good couple of years. Used to go down, do big cases with him. Back then, a big case was maybe 10 veneers or something like that. I’d still dibble my hand in endo, do some private endo for him, and stuff like that.

Kailesh: And his main thing was, “Kailesh, just come and actually just do the consults. If you do the consults,” and he says, “and I’ll do the treatment,” because he knew if I did the consults, it’d get great uptake, and then he could jump in and as the owner of the clinic say, “Well, Kailesh isn’t here throughout the week, but I can do it for you.” And we worked as a bit of a double team, and it worked super well for him.

Prav: Bro, you’re probably one of the highest grossing dentists in the UK, if I do say so myself. What’s your secret to sales, what does your consult sound like? A patient comes in, just take us through that experience of a patient coming in and meeting you for the first time on what that’s all about, from Doris who’s a 75-year-old old dear, to your young influencer who comes in, and they’re both totally different people. Surely you can’t have the same approach with them all.

Kailesh: No. Of course. It’s very much understanding people. And what things have helped me be that guy I suppose working in my dad’s corner shop, having to deal with the drug dealers, the drug takers, the middle class person that wants his bottle of wine on a Friday night because he’s had a heavy week in the office, to Doris, who walks the shop on a Thursday afternoon with her wheeling bag and gets exactly the same things each time. And having the ability to have a conversation with all those different variations of people, allowed me to build that in my repertoire.

Kailesh: So when the influencer comes in, I’m current. I know, I understand language, I’ll talk to them in the language they understand. If Doris comes in though, I will say to her very gently, very quietly, “Okay, nice to meet you. I hope everything’s okay. Did you manage to find us all right? Did you mange to cope with those…” just things that I know that they’re empathetic with. And empathy is a very big thing for me. And I’m not putting it on, I’m not faking it. I’m always genuinely wanting to make sure that they’re okay, and whether it is the influencer, or whether it is the 75-year-old dear that comes to see me, of course my approach is different.

Kailesh: I talk to them differently, the language I use is different, the way I sit, the way I conduct myself. The way I’ll either give body contact or no body contact. All these little things just to create some reassurance massively helps. Yeah. My uptake is mega. It always has been. Everyone that’s ever worked with me, or worked for me, or worked alongside me will tell you, I can literally get 95% uptake of all treatment plans. The only times they don’t go ahead is if they can’t afford it, end of. And past that, they will go ahead. And so, it’s easy to, I don’t even think about gross figures, it’s easy to do a lot of dentistry if the person trusts you and allows you to do it. And I think that’s what I do on a day to day basis.

Payman: But okay, you build trust. And you’re saying you almost do that as a second nature thing. You don’t go, “Oh, I’m going to build trust with this person.” That’s the person you are. You build trust. But then, from such an early age to be treatment planning comprehensively, and having the confidence to come out with a 20,000 pound treatment plan as a VT, I mean where’d you get that confidence from? I mean, both of you are quite confident people. [crosstalk] Where does that come from? From working in the shop? Plenty of people work in a shop, guys.

Kailesh: Yeah. No, I get what you’re saying. But from my point of view I suppose there’s two things. There’s the ability to have the confidence to almost talk the talk, and then the reason I did all the post-graduate, and I wouldn’t say they’re not MSCs, they’re not three year degrees or diplomas, or this, that, and the other, but I’ve got the hands-on experience to be able to take that to fruition. I’m not telling you that over that time I haven’t made mistakes.

Kailesh: And I think if any dentist who does the level of dentistry that I do, turns round to you and says, “Everything that I do at every point in life is amazing,” I’d question that. Massively question that. Everyone has bad days, everyone has treatment plans which don’t go quite to plan, even though you feel your special tests and everything you’ve done is good enough to hold that treatment plan up. Some things do just go wrong. Sometimes shit just does happen. And essentially that’s also learning, that’s also taught me a lot. That now allows me to make even better clinical decisions for patients.

Payman: Kai, take us through a typical day. Not your busiest day, yeah? A typical Kailesh clinical day. A Kailesh day. What time do you wake up? What do you do? What time do you get to the clinic?

Kailesh: A Kailesh day. Okay. So I usually work four days a week. So my working week is Monday, Tuesday, Wednesday, Thursday, I have Friday, Saturday, Sunday, Monday off, and then the following week I’ll work Tuesday, Wednesday, Thursday, Friday. And so, I try to keep that structured so that I do have some time off. Because when I’m in, so let’s talk about a regular day now, I’ll start my first patient probably 7:00.

Payman: 7:00.

Kailesh: So I’ll be waking up at 6:00 usually, sometimes I’ll do a bit of exercise before I shower, get out the house from maybe 6:30, into the clinic at 7:00, first patient 7:00. So my team are already started. My team are there at work at 6:00. So they’re ready. At 7:00 I’ll probably maybe do a full arch immediate load case. So there may be some extraction work, sedation work, take teeth out, place some implants, and restore that with a fixed bridge.

Kailesh: So let’s say that’s patient one. That’ll be completed, the surgical aspect, about half-past 8:00. So by about half-eight, I’ll probably generally have a coffee, wait for the team to clean up. So about a quarter-to-nine to 9:00, I’ll have my first patient then… well I’d class as my first starting patient. Because my 7:00 patient is generally what I would class as before hours. So I pick and choose who goes in those slots. Not my team. So like 9:00 I might have 20 veneer preps, that’ll take me to maybe 11:00, 11:30. And then-

Payman: 20 veneers in two hours?

Kailesh: Yeah. Like to prepare them. Yeah. I would say unless it was really compressed, comprehensive, complex perhaps, if I’m working conformatively, generally, and if I’m working maybe facially only, I’d put two hours as ample for 20 veneer preps from my point of view. That will be an anaesthetic, prepped, temporised, photography, everything from start to finish in respect to that. And then, about half-eleven, maybe do a few consultations. So two or three consultations, and then probably lunch at one. And then maybe we might have some restorative work. Then in the afternoon [crosstalk 00:28:47]-

Payman: Do you work over lunch or do you stop?

Kailesh: I generally stop. Generally if I have about half-an-hour to 45 minutes I’m cool. And then, I’ll start back again. Maybe some more consults after lunch. Usually a few single tooth implants thrown in in the midst of the afternoon. Maybe some more preps or some more fits. To give you an idea, I’m generally… I was working my day off on Monday, I had a 20 unit fit case, and a 20 unit fit case, and that was being done, but I chose to come in for them. So I started my first 20 unit fit case 7:00, that was done by 9:00. My second 20 unit fit case started at 9:30, that was done by 11:30. I was out the door for midday. I had other things going on, meetings and so on.

Kailesh: So I still had pretty much my whole afternoon, and I’d fit 40 veneers in the morning. But essentially I work reasonably quickly. I think people see that. And even my associates that come in they just say, “We can’t do it like you.” And I don’t expect anyone to work like me. I work like myself, I work like this, and I wouldn’t know how to work any different. I don’t work any slower, I don’t work any faster. I’m not trying to rush. It is just that’s the level of time stuff takes me. A single tooth implant, if it’s not complex, it’ll take me five, 10 minutes. Full out it should take me an hour. If there’s no extractions, it’ll take me an hour-and-a-half for those extractions. It’s just the way I work. And I suppose on the basis of those times, then your gross fees go up. But that’s not the reason I do it.

Kailesh: If you told me to prep a 20 unit case and do it in four hours, I would have no fucking clue what to do for two hours of that four hours. That’s my problem. Do you know what I mean? Do I polish my preps? Yes. Do I use magnification to prep all my teeth? Five times magnification for every bit of work I do inclusive of implant work. Do I feel I provide quality in what I do? Of course. You see my cases day in and day out on social media. And I don’t hide stuff. I don’t hide stuff with lips and this and that. I use full retracted shots to showcase my work. So from my point of view, I know my work stands up to most people in this country. But essentially it is just doing it at the speed it’s done. That’s just the long and short of it. But that’s then my working day.

Payman: [crosstalk] Do you know how many implants you do a year, or how many veneers you do a year?

Kailesh: Implants is easier, because obviously I get the notification. So I’m [Nearden’s] biggest placer in the country, so I place I think last year just under 700 veneer work. My technician tells me probably close to 4,000 ceramic cases-

Payman: [crosstalk] And a bunch of composite veneers in there as well, right?

Kailesh: Yeah. So obviously it’s become quite big, that. Composite veneers are one of those things now that everyone’s doing. I think there was a few clinics that Dental X, [Lintz’s 00:31:50], and those clinics that started doing them quite massively. A lot of people are injection modelling these things and trying to speed the process up. But you don’t need to speed the process up. You definitely don’t need to do things like injection modelling. You can do a good, quality, single coloured composite veneer casing in two hours, two-and-a-half hours, 10 units. That’s what I do it in.

Kailesh: And I think there are processes out there and people are trying to say, “Oh, well we can do these quick. We can do this like this, we can do this like that.” In actual fact, once you know what you’re doing and you’ve got the experience and the artistic ability, they’re pretty simple, quite straightforward treatment. So yeah, I do a lot of that as well. I do a lot of composite veneer work. Probably some weeks 40, 50 veneers, composite wise. And yeah, it’s just another skill set. People do stuff, so you think, I could do that. It doesn’t look that complex.

Kailesh: I learned from Andy McLean, who worked for the Kiss for three, four years. And did my first case, it was okay. Did my second case, critiquing it. By fourth or fifth case I was like I love this. Because it does give you a lot of satisfaction at times. You rebuild a whole smile in composite and it’s all freehand, and it shows off what you can physically do. So [crosstalk] it’s lovely.

Payman: Do you remember when we started doing composites back 10 years ago, I actually came to you and said, “Do you want to be the composite guy,” and you said, “Nah, I haven’t got time for that.”

Kailesh: [crosstalk] Yeah. And do you know-

Payman: [crosstalk] Do you remember?

Kailesh: Yeah. Of course. It’s one of those things back in the day 2007 to 2010 I was the Cerec guy. And people probably don’t remember, but I did Cerec before all of these guys that are doing it now. All these guys who are saying, “I’m the Cerec king, and I do this, and I can do a same day crown, I can do a same day veneer.” I was doing that shit in 2006. I was getting technicians in, doing full 10, 20. I’ve still got cases come in 15 years on that have got 20 veneers done in Cerec all done same day. So from my side, I’ve been there and done all that. But for me I was running the business as well, and I’m growing the business as well, so I’ve got to make sure that I do the things which are going to be the best for the business.

Kailesh: So Cerec was great. It was a great product. But is it as profitable as me prepping 20 units and sending it to my lab, and me cracking on and doing something else? Of course it’s not. So then that essentially is then the approach I need to take, moving onto implants as opposed to doing composite veneers. The reason I did do composite veneers was two reasons. First reason is, can I do it? I wanted to know because I’ve done everything I can physically do in dentistry, and apart from endo, I’m not a big fan of, and like posterior composites and stuff is just not my bag. But anything a bit more complex I want to make sure I’ve got that skillset. So that was the first reason.

Kailesh: And the second reason is, I don’t want my clinics to ever be behind anyone. So if there are clinics around me that are doing that, I want us to be the best at it. But to be the best at it, I need to understand how to be the best at it. And that’s why, for me, it was important that I could do it. And I could do it to a very good standard so I could then say to my guys, you’ve got a benchmark in your own clinic, and that’s what I need you to be able to do. Because as I don’t know if you guys know, but I run a private VT scheme and I have been doing that for the last three to four years.

Kailesh: And so, I trained newly qualified dentists that have literally just come out of university and ensure that if they want to go into the private field of dentistry that they are armed, they are well educated, both by myself and independent courses that I generally recommend, and make sure that these guys are well protected as well by the group that is Kissdental that is headed by me. And allowing them to feel safe, but not to be scared. Not to just want to align, bleach, and bond, because it’s easy and there’s less issues and less people are going to see them. I want the dentists that I produce to be all around very good dentists, if they want to, to provide comprehensive dentistry, advanced dentistry, safely, and to the best interest to the patients.

Payman: Amazing. I mean, I’m sure doing any stint of time with you is one of those things they say surround yourself with people better than you. Tell us about a failure, Kailesh. What’s been your biggest clinical failure? Your biggest mistake you’ve made clinically? We’re asking everyone.

Kailesh: Biggest clinical failure. Let me think. Difficult really. I think there’s cases that come to mind, clinically. I suppose my biggest one was treating a patient who basically had radio and chemotherapy previously, thinking it was going to be okay. Explaining to her the risks of radio osteonecrosis. We were doing some implant therapy for her. Well, we needed to do extraction work for her. Her teeth were falling out. Would have the outcome been any different if I would’ve referred her to the hospital? Probably not. But she did get radio osteonecrosis and it always plays on the mind that did I do her a disservice?

Kailesh: I don’t know. I still don’t know. A lot of the times when you get issues or clinical failures you kind of sit around to yourself and say, “I wanted the best for the patient at all times, and that’s how I’ve always worked.” And past the business side and everything else, I want everyone to know that hears this, I am a clinical dentist that loves and has a massive passion for providing dentistry. And all my patients hopefully would say he genuinely does care, and I do. Yeah I make a great living out of it. I don’t ever hide that fact. Listen, I’m not some young guy that shows off his Louis Vuitton belts that he’s buying, or his new Lamborghini that he’s just bought.

Kailesh: I’ve got all those things. I don’t care. Essentially, I’ve been that guy, again like I said, for many, many years. And I’ve gone through that motion of this is what I’ve got, and this is how successful I am, and yada, yada, yada, yada. But in the end, I’m a clinical dentist. And that’s what I want to be known for. When you look at my Instagram, is it all about me? No. It’s about the teeth I provide, the smiles I do, it’s about wanting to showcase the beautiful work I feel I do to ensure I get more patients through, and make sure that Kissdental thrives. So I think I don’t know if that answers your question, but-

Payman: [crosstalk] It does. It does. I mean, there’s one example. But I wouldn’t beat yourself up about it. The volume of work that you’re doing over the number of years that you’re doing that volume, I mean I reckon in the last 15 years you could’ve done more work than 20 dentists put together. If stuff wasn’t going to go wrong [crosstalk] it’s a huge amount of work.

Kailesh: And I’m very pragmatic about it. I don’t look at a complaint that comes in and think god. Because you’re right. I’ve got to look at the level of work I provide, the risk of work I provide. And every year I’m better. Every year I feel I handle things better. But that can only come with experience. You can’t be that guy in 2004 or 2005, just graduated. I can’t provide the quality of what I provide today back then. I didn’t have the experience. And one unfortunately will not come without the other. So you have to have that. I didn’t have a mentor like me, so I had to do things myself.

Kailesh: And everyone, not everyone it’s unfair to say that, but a lot of people say this young kid, who’d opened his cosmetic clinic, tried to go for all the awards, tries to do all this dentistry, goes to every course under the sun, and just thinks he’s going to be here today, gone tomorrow, him. He’s fly by. And we’re 15, 16 years on. Kissdental has got a massively great reputation in the northwest. We get patients now from all over the UK. Our Instagram following, our social media presence, our just presence just generally is super good. And that is testament to us holding our ground, or Kissdental holding its ground and saying, “Listen, we’re here to stay,” from my point of view.

Kailesh: And now, I think moving forward long-term plan is to ensure that maybe I can be a mentor for some people. I do it now in my private VTs and they do super well. I’ve got my private VT that’s going to be moving to [Fee Brigthum 00:41:06] just in the next coming month, and before that, he’d studied dentistry in Latvia. So it’s not like he had experience in UK dentistry. It’s not like his mom and dad were dentists. It’s not like he’s grown up in the profession all his life. We was wet behind the ears. He had no idea of dentistry. And for him to safely, that is the key, to safely providing very good quality dental treatment, not rushing. And this kid doesn’t rush. He still shadows me one day a week.

Kailesh: So he’s still only doing four days clinical dentistry a week. And for him to gross 100k in one month before he goes [inaudible] great for me, great for my business. But that’s not the reason I’m doing it. Because I’m producing, I’m hoping, not lots of mini-mes, but I want to produce people that are not scared, that understand dentist is something that needs to be provided past a basic level, but happy to provide it. Because he knows I’m his mentor, I will help him, I will go through that with him. And I will go through every journey with him. I check his preps, I check his imps, I check his final fits, I check his [crosstalk] tents, his treatment planning-

Payman: [crosstalk] We used to talk about this here. Prav and I have talked about you. I mean, you introduced emergency to Prav, let’s start with that. You introduced me to Prav. And Prav and I have talked about you a lot, and Prav does marketing for hundreds of dentists, and he says that in the end, you are the one of all of his clients, who converts the most.

Payman: And then this question of is it just, okay some people have an X factor and they can do things, or is it teachable? And now you’re telling me, it’s teachable, which is different to what I thought. I thought okay, Kailesh is special. There he is. Since you were saying you were grossing and knocking people’s socks off from VT. All right. You’ve got something. But the idea that it’s teachable, that’s beautiful.

Kailesh: Yeah. From my side we’ve had two VTs now have gone through the programme up to now. I would say, before my second VT, my biggest success and biggest failure. Biggest success because I felt he was the right fit. I felt he was genuine in what he wanted to achieve and the reasons he wanted to do dentistry. And I think I’d say he’s my biggest failure because although he again did super well year-and-a-half in, I moved him from a salary to fee per item I think too quickly, because he was quite greedy if I’m being honest. But he was my cousin, and I wanted to help him. Everything we had, which was verbal, it was a verbal agreement, and he basically let himself down, he let the agreement down, and so on the basis of that, my biggest failure.

Kailesh: But while he was with us, he was smashing numbers. Was it teachable? 100%. Was he wet behind the years when he started? 100%. Did he know about dentistry? He couldn’t do a composite in two hours this kid. He was academically amazing, academically super clever. But it took him two, to two-and-a-half hours to do a posterior composite when he first started. That’s the level of these people that are coming through the dental hospital. When he finished with me, when he left, and he left on bad terms and I’m open to say that, but when he left he was taking home 13 to 15k a month a year-and-a-half in. He could speak to patients, he could get acceptance of treatment plans, he was clinically getting better and better.

Kailesh: And I feel for him. In the future I hope one day he understands that in the end I was only trying to look after him, because he wasn’t ready to go out in to the big bad world yet. Not in private dentistry. But that was his choice, whereas the next associate I’ve been super strict with. It was all contracted. It’s all been followed by the book, the programme has improved, and I think the education level for him has improved, and the proof is in the puddling. We now have taken on two more new VTs, and I honestly believe that in three to four years time, I’ll have a team of these guys that will A, do super well for themselves, but will do so for Kissdental as well. I’m building a team up. I always think of people like Alex Ferguson when he built United right from the start.

Kailesh: And I’m not a massive football person, but I understand his ethos, I understand his ethics, I understand actually I’m not going to buy these people at real big money, I’m going to invest right from the start. It’s going to take time and energy. And I’m happy to put that time and energy in because I know I will produce these super stars, because I know it’s teachable. And both of those two guys that I’ve already taught it to are testament to that. I mean, you see all these people now, two years they’ve owned a practise. All of a sudden they’re giving out business advice like they’re some business gurus. I’m like, you guys are kidding me. I’ve ran three practises for 15 years. I’ve been through recessions, I’ve been through floods, storms [crosstalk 00:46:31]-

Payman: But to be fair, you were doing the same when you were a new boy as well. You were. You were. You were.

Kailesh: [crosstalk] But I wasn’t-

Payman: [crosstalk] It’s a level of confidence people have. You were doing the same. You came out of dental school running a Cerec course I remember. That’s where I first met you, right? It was a double side.

Kailesh: But what I’m saying is, understand your mentor has got to be… there’s got to be some volume in what you’re gaining.

Payman: Sure. Take us back to when you decided [crosstalk 00:47:04]-

Kailesh: [crosstalk] And that’s what I’m saying.

Payman: … to do Kissdental.

Kailesh: Okay. So Kissdental was basically born from me wanting a clinic, and I’m very impulsive, very, very impulsive when I purchase things. My shoe collection will tell you that. There’s about 1,000 pairs in there. And-

Payman: You’re not joking.

Kailesh: I am not joking, no. Unfortunately I’m not joking. I wish I was actually, but I’m not.

Prav: Bit more expensive [crosstalk] than night trainers and it was lonely.

Kailesh: Yeah. I know. That’s the reason why I wish I was joking. So basically I wanted a clinic, and there was a clinic on the market. And it was funny actually, I had a really close friend at the time who was a dentist. And I said to him, “I’m thinking about buying this practise.” And he said to me, “Oh, no. Don’t buy that. It’s a lemon. A lot of my friends have been to look at it.” He already owned a clinic in Manchester, may I add. And he said, “Oh, don’t buy that. It’s a lemon. The numbers are poor on it and so on and so forth.” So I kept looking at it, and in the end I thought do you know? Screw it. I’m going to buy it.

Kailesh: I didn’t actually have a lot of money. I had sold the computer business, I had about 50k of that money. I’d worked a little bit, but I’d been spending. So it was what it was. I put a business plan together, I managed to get funding from the bank. Back then, we’re talking 2004, ’05, they were giving you money for whole rope, they were giving you like 110% loans. So it was happy days. So I got a 500,000 pound loan, bought this clinic. I think it had something like 200,000 pound was the building, and 300,000 was the goodwill. I lost pretty much all the goodwill day one, so now I had a 200,000 pound building with no goodwill. And I decided to spend about 400,000 doing the place up. So I was in debt for about brinking on a mil.

Kailesh: I hadn’t even opened the doors yet, but I had brilliant branding. I called it Kissdental, I got these designers to do everything, I got a website. Before I bought it, it was called [Woodsen Circle 00:49:13] Family Dental Practise. And the population base was 65 to 80, all coming in for their little cleans and polishes, and that was it. And I was saying I’m going to open this fantastic cosmetic clinic in Manchester and we’re going to provide all the outskirts and people are going to travel from the city centre, and so on. And that was my business model.

Kailesh: We were close to the network links, we were close to a train station, we were close to the motorway, and we were close to the traffic centre. And from my point of view, they were landmarks, people would come to us, we just needed to open our doors and crack on. And that didn’t quite go to plan, because literally within about a year-and-a-half to two years I was severely in debt, the business wasn’t doing how I wanted it to go, and really, it was a real struggle.

Kailesh: And because I was doing such good numbers, it was the only reason it was staying afloat. And Pravish was just finishing university, and I’d said to him, “Listen I need your help.” Because I’ve got this marketing company that are smashing through the money like this is going out of fashion and I think one month we’d spend with a PR marketing company I think we’d spent 80,000 in one month. [crosstalk] And I was like [crosstalk 00:50:34]-

Prav: [crosstalk] And that was back in 2006.

Kailesh: … [crosstalk] when you come home from university… Yeah. Yeah. And I was like, “I need someone that can do this shit for me and not charge me the money.” And he was like, “Right. Let me see what I can do.” And he’d just come back from uni, didn’t want to do medicine anymore he’ll be happy for me to say, in a position where he was just in limbo land. And I said to him, “Fucking do marketing. I’m telling you, you will make a cream. You’ll understand it within days, and you’ll smash it.” And it’s essentially what you did, wasn’t it? And-

Prav: Yeah. And the one thing I’ll say is that he gave me an open chequebook, and he gave me full autonomy. So he said, “If it’s good for the business and you think it’s good for the business, spend the fucking money.” And those were pretty much his words. So it was full pages in the Manchester Evening News, it was splashing it all over the radio, it was Google AdWords, it was everything you could think of to get coverage. Sponsoring gyms, TV screens, everywhere you looked in Manchester our brand was out there. And I think we made a lot of mistakes back then. We spent a lot of money and didn’t get return, but it put Kissdental on the map. Road signs, roundabouts, billboards, you name it, it was all over the place. And I guess that’s where I started learning my craft.

Kailesh: Yeah. And I think it went well for both of us, because then I used to go and do my Cerec training. People would say to me then, “God, I’ve seen your marketing, I’ve seen your website, I’ve seen this.” And I’d say, “Well, there’s a real good guy that does it for me.” But I never wanted to say it was my brother, so I was like, “This company called [The Fresh 00:52:16] would do it. Maybe speak to them, they might be able to take you on as a client. They’ve done fucking super well for me.” Because the problem was I didn’t want to cloud their people’s judgement and say, “Yeah, my brother does it for me.” Because I wanted him to be his business in his own right.

Kailesh: Even like I said to you right at the start of this that I was always in Pravish’s shadow. And I think if Pravish became a dentist, I would have stayed in his shadow. Luckily we’re super diverse in the things that we do, so I would hope people would say we’re businessmen in our own right. And so I didn’t want him equally to be part of Kissdental. It was never the plan. It was never that he wanted to buy into my business, and neither did I want any piece of his business. I always said we want to help each other. But I didn’t want to help it on the basis that help him out because he’s my brother.

Kailesh: I wanted him to say, “Speak to this guy, see what you think.” And once he spoke to him, again, it was a done deal for them. And so, for us, both our businesses grew exponentially, because I think it was our synergy just super worked. And anything he wanted to try, any new idea, he tried it with Kissdental, fucking brilliant. And if it didn’t work, he’d be like, “I’m not going to fill it out to my clients,” and if it did work, he’d be like, “Super, I’m going to now fill it out to my clients.” So it’s fucking win-win for him. I was still spending the money, but in the end for me it was about that growth and being on the map and knowing that actually we helped each other, really.

Payman: But then, guys, I mean I get the picture of this in his shadow and all of that, but isn’t it strange that now Prav owns other dental practises, and you guys could’ve done an empire together?

Prav: If I’m speaking honestly, we’re like chalk and cheese, mate. And I’m being open and honest here. I love my brother to bits, right? And would do anything for him. But I couldn’t go into business with him. And I think he’d probably say the same about me, is that we are very, very, very different in the way we operate our businesses. And for that reason, I don’t think it would’ve worked.

Kailesh: Yeah. I mean, I’m a very emotionally driven person. I buy off emotion, I work off emotion, I wear my heart on my sleeve, it sometimes gets me in a lot of trouble. I understand that. But then also, it’s one of my big strengths as well. Whereas Pravish, he’s so calculated. If it doesn’t make sense on a numbers model for Pravish, it’s done. And I don’t care if he’s known the person for 25 years, has like wet fed his kids and shit like that, he’ll still sack him. He’s got like zero care. Zero care. There’s no emotional attachment there.

Payman: I get it. I do get it. But often those partnerships are best when the two partners a very different. I mean, look at me and [Sanj 00:55:28]. Totally different to each other. But I’m not saying that you have to go into business together, because you’re both super, super, successful, and it seems to have worked well. It’s not like there’s regrets. But for me it would’ve been a nice thing. And it could still be, right? Going forward something like that could happen, right?

Kailesh: Yeah.

Prav: [crosstalk] Who knows?

Kailesh: Yeah. You never know. But I think as well, mine and my brother’s relationship works super well, and I think it works super well because he’s got his own thing going on, I’ve got my own thing going on, he’ll ask me his advice on certain things, I’ll ask him advice. And it works that way. And he gets involved when I need him to. I’ll say, “Bruv, can you sort this out for me? Can you sort that out for me?” And he’ll be like, “Yeah. Of course I will.” But I just think clouding our relationship with business because we’re family as well, I think it would create a dimension which I think would be difficult for us both. Because we both are very headstrong as well.

Payman: And your dad’s involved in both businesses to some extent, right?

Kailesh: [crosstalk] Yeah.

Prav: [crosstalk] He helps with finances, so-

Payman: In both sides?

Kailesh: In both businesses, yeah. He does like my bookkeeping now, he does all that accountancy side of things, the daily stuff. Making sure the money’s come in, the money’s gone out. He stops me spending money, basically. So he limits how much money I’m allowed every month which is a fricking nightmare when I need something, like when I want to buy a new car or something like that. I have to go cap in hand like I’m about 14 again, “Can I have this money dad, please?” Even though it’s my own money.

Kailesh: But to be fair, he keeps my grounded to a way. I am a spendaholic. I will buy stuff and buy stuff. I can spend it quicker than I can earn it, so for me to make that statement is quite worrying. And my dad knows it’s worrying as well. So he says to me, “Son, I’m quite happy with you having nice things and doing stuff, yada, yada, yada, but you really also need to ensure that you’ve got something for the future.” And I get that. And so, he keeps me on the level and he makes sure I’ve got savings and all that kind of stuff.

Payman: So Kailesh, you’re quite out there in the Manchester sort of scenario, right? You’re known.

Kailesh: Yeah.

Payman: When we do Mini Smile Maker in Manchester, you take us out and every person, every doorman, in the street, people recognise you and all that. But it kind of worked out against you at one point, wasn’t it? These guys came and… tell us that story, man.

Kailesh: Well, I think what genuinely happened was I treat a lot of variation of people. You get to be known in Manchester. And I was known to treat probably some of the unfavorables, but they come in, their money spends as well as your middle class guy who’s just bought a Porsche, these guys are coming in track suits or shorts and mainly pay in cash and things like that. But essentially I treat them all with the same respect, and that’s where we go back to that same conversation, how do you treat that person different to the other person? Of course it’s a different relationship.

Kailesh: But I was quite, I would say flash is the wrong word, I like what I like, I loved watches back then. I thought of nothing about wearing a 100,000 pound watch on my wrist, to give you an idea. I used to wear it to work. I used to wear it to the gym. You know what I mean? It wasn’t the fact that I was posing, showing off my 100,000 pound watch. I like watches, I liked that watch, I’d wear it. And I’d wear it if the drug dealer came in, I’d wear it if a classy gentleman came in who appreciated nice time pieces. It was what it was.

Payman: It was your watch.

 

Kailesh: But it attracted a lot of attention. Yeah. What was it? It was a-

Payman: No, no. [crosstalk] It wasn’t what was it.

Kailesh: … [crosstalk] AP-

Payman: I’m not saying that. I’m saying it was just your watch. As far as you were concerned, it was your watch.

Kailesh: It was the items that I wore, yeah. And it was just my watch. I also like to see my cars. And I’ve got a lot of cars. And I see them as [crosstalk] vehicles-

Payman: [crosstalk] So what happened? What happened?

Kailesh: … [crosstalk] and I like nice vehicles.

Payman: What happened?

Kailesh: So we have a full security system at home. I go downstairs and my wife shouts me and she’s like, “Someone’s outside. Someone’s outside. I’ve seen them.” So I look on the CCTV and I see three masked men outside roaming the side of the property. At which point I said, “Go upstairs, I’m going to try,” and at the time our alarm system had some panic buttons, but they were downstairs. It was all a bit of a mess. So I aimed to run through the kitchen where we had these large bi-fold doors. Press this panic button. I’d already rang the security company to say there’s somebody on our property.

Kailesh: And as I run through the kitchen, one of them sees me, he smashes through… It felt like it was instantaneous, but literally I froze, I was wearing no top, I remember I was wearing a pair of shorts. He just had this sledge hammer. He smashed through this patio door and literally within seconds he was on me. And he had a hammer to my head, and the other guy then ran through and he had a machete to my neck. And they just said, “Get me your watches.” And at which point I said, “Listen, no one’s getting hurt here. I will give you what you want.” And at that point they started saying, “Fuck it. Obviously hurry up.” They roughed me up a bit, hitting me a little bit, which it was what it was.

Kailesh: Obviously we had a safe at the house, so I opened the safe, gave him everything that was in the safe. I mean, and it’s not unknown, it was about a quarter-of-a-million quid that they took, at which point my wife was screaming upstairs. She then was forced downstairs by one of them. My two young children at the time were probably one and two. Luckily they slept through the whole thing. And obviously my wife was distraught and I was like, “Stay calm. I’ll give you everything you need.” And they said, “If you don’t hurry up we’ll kill your children. We’ll go upstairs and we’ll kill your kids.”

Payman: Whoa.

Kailesh: Which was quite like obviously it’s upsetting and you don’t know what these people are capable of, so you’re just trying to keep them downstairs, just trying to keep them downstairs, and trying to pray that the kids don’t wake up. All this is happening and you think it’s taking 20, 25, 30 minutes. I think from start to finish when we looked back at the CCTV, the whole incident was six minutes. Obviously shook up. People get traumatised by these things, and my wife especially, Michelle, was super traumatised by it.

Kailesh: Myself, of course I was upset about it, and I was upset about the not being able to be the person I am, because I felt like I was reducing the person I am. And those things don’t make me the person I am, by the way. It was the fact that I couldn’t wear those things. Do you know what I mean? For me it was super important. That’s my persona, that’s who I am, that’s what I like. So why can’t I do things I like anymore? Why are these people restricting me? But then, two months later, they came again to the practise.

Payman: Oh my goodness.

Kailesh: Did it again. And then held up some patients and all sorts of stuff. So that was the second incident within two months. So at that point for the safety of my family, the safety of my staff, I decided that maybe it’s Apple Watch time and just toned down that aspect of my life. I didn’t mind. If it puts me in danger, then I take that risk myself, like anything in life, don’t you? You want to drive at 120 miles an hour in your car? You put yourself at risk. If there’s no one else in the car, all right, you might put other road users at risk, but you make that decision yourself. When you’re in now I’m putting all my staff at risk, I’m putting my family at risk, in the end I said this is not for me.

Kailesh: Did it traumatise me? Initially, yeah. But and Pravish will openly tell you, we worked in a corner shop in a counsellor state. People used to come in with fucking balaclavas and bats every bloody over day trying to do the place over. It was almost a passing joke like are you actually going to use that or do something, or are you just going to… what are you going to do? And the majority of them, you fucking knew who they were behind the balaclava, they’re just local kids from the counsellor state. So I’d just be like, “Jack, can you take the fucking balaclava off? You want a bottle of milk until next week, I’ll give it ya, but you don’t need to try and rob us.” You know what I mean? And it would be a bit like that.

Kailesh: And I make it a bit funny and I put a bit of jest into it, but essentially we did get confronted with those things growing up. So did it traumatise me that badly? No. Am I more weary? 100%. Do I wear those things now? No. Would I love to? Of course I would, because I enjoy those things. Some people enjoy what they enjoy. Some people like alcohol, like a nice glass of wine or a nice whiskey, then you should be able to enjoy that. I enjoyed wearing a nice watch. I enjoyed those things. And now I can’t do it. But I don’t do it because I want to make sure that I don’t put anyone at risk. That’s the key thing. But it was a shit time. A really shit time.

Payman: Yeah. I bet. What do you reckon going forward, Kai? You’ve achieved so much in dentistry as far as a practise situation, and definitely one of the most successful practises in the country and all that, but what are your ambitions going forward? Where would you like to go in the next five, 10 years from the professional perspective, what would you like to achieve?

Kailesh: I’d like to do more on the education side, if I’m being honest, Pay. Both from the mentoring side with like minded dentists that want to do better, want to perform better, want to achieve more. I love the education. I run obviously an implant course twice a year for [Neasden 01:06:27], like single teeth and full arch. We’re currently setting up a little composite veneering course for people that want to do freehand veneers.

Kailesh: And I want to just build on that, but not just doing dentistry based courses. I want to, I think in time, build upon that mentorship programme. I want to feel like people can come to me and trust what I say, trust my clinic judgement on certain things, and feel secure and safe in providing dentistry. I feel the profession at times is dying because not as many people are providing comprehensive treatment.

Payman: [crosstalk] People are being defensive, aren’t they?

Kailesh: People are being too defensive. And I understand the reasons why. Listen, have I been sued? Of course I have. The level of dentistry I do, you’d be fricking nuts if you didn’t think I had. But does that stop me doing what I believe is right day in and day out? Absolutely not, no. And I want dentists to understand that. And I’m not saying it’s for everyone. And some people are super anxious, some people are scared and worried, and they can’t get past that anxiety to then provide certain things. I get that. But there are some clinicians out there that I think really want to. They just need the handheld in the right manner, and have the right dental level of education. And that’s what I was saying about mentorships before. I wasn’t trying to take the mick out of anyone, or belittle anyone.

Kailesh: I just believe if you’re going to use a mentor for a certain particular thing, make sure they know what they’re doing. Make sure they understand the hooks and crooks of dentistry, or the business of dentistry. You can’t understand the business of dentistry by running a dental practise for one or two years. You just physically can’t. It has to be ran successfully for a period of time. Has it grown? All right. You’ve got one successful clinic. Can you emulate that? Can you create two? Can you create three? If you can do that, then listen, I’ll hold my hands up and I’ll say, “Maybe I’ll take some advice from you.” But equally the same in dentistry, if someone wants to understand full mouth rehab, go to someone that does a lot of full mouth rehab. Let them hold your hand.

Kailesh: And I’m not saying that me every time, but what I’m saying is, I have that experience at level to say to a lot of people that I will help you, I will guide you, and I think make you a better dentist both clinically, both the way you speak and converse with your patients, and also give you better uptake. And I think in the next five to 10 years, that’s where I want to be. I want to be that guy that helps other people. I don’t want to retain all this knowledge and think yeah, it did well for me, but screw everyone else. I want people to say, “Do you know what? He was a top guy, and he fucking taught me a lot, and I am where I am today because I listened and I used what he said, and I moulded it into how I wanted to do it.” Because that’s important as well. I don’t want you to be me. I want you to be you with the tools that I teach you.

Payman: Okay. I can understand with these VTs immersed in the practise with you, you can teach it. If the average GDP turns up, how long will it take to learn?

Kailesh: I think two years.

Payman: Two years.

Kailesh: It’s going to be a two year programme, I think. The problem is, people that are already set in their ways, that have already worked in general practise for a period of time, they’ll have their own ways to do things. I’ve had a lot of associates that have come in and said, “This is how I want you to start doing things. This is how it should be done. I’m not telling you the way you did it previously was wrong. I’m just telling you it wasn’t how we do it. And I need you to do it how I do it. And then and only then will you learn, and you learn to stand the processes and why we get the uptake we get.” And some of those guys just don’t want to do it. No matter what I do, no matter what I say, no matter how much I try to instil it in them, getting them to mend. But then, were they the right fit in the first place?

Payman: Kai, the amount of work that you’ve done, the volume of it, you’re bound to have a bunch of clinical tips, efficiency hacks, in implant dentistry and veneers. Can you think of a few things that you’ve come up with? At the rate that you’re working, you must have. I mean, one you said to me was you’ve got an extra nurse that does all your notes on top of your nurse.

Kailesh: Yeah.

Payman: Kind of seems obvious, but I’m willing to bet you might be the only dentist in the country who has that.

Kailesh: It’s the simple things. It’s all the things that you can delegate out that doesn’t effect you clinically. So I have two nurses at all times. Do I need two nurses at all times? Of I don’t. But essentially one is going the clinical work with me, the other one is writing all my clinical notes. Then one, when you have downtime, is writing on my consent forms, is going through all those aspects of things that I then don’t need to stress myself about.

Payman: Super important. But actually, on the clinical, the way you set up-

Kailesh: Yeah. [crosstalk] clinical-

Payman: … the way you do things, tell us, how do you [crosstalk 01:11:53]-

Kailesh: [crosstalk] Little things.

Payman: … sneak that many implants in in one patient in that time frame?

Kailesh: It’s because you’ve efficiently used your time. When I’ve mentored full arch for dentists, the biggest problem is, they have no confidence in what they’re doing. So even from cutting the flap, to giving the anaesthetic, to placement of the implants, they will faff. I mean, I went on a course to Brazil, three years ago, a full arch course. I did my full arch. It was hands on. I did my full arch, hour-and-quarter. Now I was not doing the restorative, because they did the restorative in a very strange way out there, so I let them crack on and do that. So I did my surgery from start to finish, from giving anaesthetic, hour-and-a-quarter.

Payman: How long did everyone else take?

Kailesh: There were still people there at five hours.

Payman: So what is it? Where are the hacks?

Kailesh: The hacks are to I think visualise. I always visualise what I’m going to do before I do it, and I know that sounds pretty straightforward, but if you actually just look at something and go, “Right, this is how I’m going to approach this.” And then I’m efficient so I give the anaesthetic, I cut my flap, I raise it, I place my implant. But at no point [crosstalk 01:13:07]-

Payman: But it seems second nature to you, yeah? But-

Kailesh: Yeah.

Payman: … you’re definitely doing something different to most dentists, and you need to be able to bottle that, right? And discuss it.

Kailesh: It’s the [faff 01:13:20].

Payman: It’s not the faff.

Kailesh: Honestly, it’s the faff. It is genuine the faff. They will look, and they’ll look, and it’s the inability to make a clinical decision. So placement of an implant on a full arch, you would think that was pretty straightforward because there’s no fricking teeth. But honestly, the position of that osteotomy, it takes sometimes a clinician 20, 25 minutes to make a decision on that. You do that times four, you’re into an hour before you’ve made a decision on every placement.

Prav: I think it comes with experience as well. Well the volume of implants you’ve placed, you’ve been there and done that so many times, that it’s almost instinct, it’s second nature with the sheer volume of work. So you repeat that thing [crosstalk] time, and time, and time, and time again.

Kailesh: [crosstalk] Yeah. Time again. You just get better at it. That’s why I say to people, “I don’t expect you to be like me. I don’t expect you to be quick like me.” But what I expect you to do is making those clinical decisions with me holding your hand. So if you’re doing to do those preps, I want to see how you’re going to do them. I want to talk it through with you, I want you to visualise it. And then when you get in there, I don’t want you to faff. I want you to know this is what I’m going to do with this tooth, this is what I’m going to do with this tooth. I want you to prep it, and then I want you to call me through.

Kailesh: And then I will check it, and then I’ll say, “Maybe look here. You need to take a look at this prep stent, look at this reason for this, and now do this, and then go again.” But like Pravish said, it is time, and it’s energy, and it’s understanding that that’s going to take a little bit longer because it’s the first time they do it. I expect that first posterior composite to take two hours in actual fact. Don’t get me wrong. But what I’m saying to you is that’s what we when benchmark it against. Because very much like a posterior composite, if you do them all day long, really, 45 minutes is probably ample in the end.

Kailesh: And the same with a full arch set of implants. I don’t expect everyone to do it in an hour-and-a-quarter, but I think if you did it in two hours and you’re comfortable and confident doing it in that level of time, I that’s a decent level of time to do surgery where the patient is not uncomfortable. And the reason I speeded up when I was back in the day was because I’d give anaesthetic, I forgot my flap, I do this and that, and then I’d been in a situation where now the patient’s starting to feel pain, and I’m thinking I’ve got to regive them anaesthetic and so on and so forth. So from my point of view, it was to ensure patient comfort. And that’s all I want my other dentists to think and understand, really.

Prav: I think there’s so much more we can talk about, but I know were getting close to time our kid. Is there anything in particular you want to mention or talk about specifically before going to any more questions?

Kailesh: No, I think we’ve covered a lot of topics and stuff. I’m happy, obviously hopefully as I said before I started this, I didn’t want to come across as arrogant, because genuinely when people know me I’m not, or I think I’m not anyway. And secondary I wanted to come across as I love the profession. I love dentistry, and I want that to come across because it isn’t all about business for me. I am not a number cruncher, and yet Kissdental makes me a great living, it always has done. But that’s not the reason I do it. That’s a byproduct I always say. The reason I do it is because of the love of what I actually physically do day in and day out.

Prav: And what’s the dream? One day sell the business or open more clinics? What’s the dream for you?

Kailesh: I think moving forward with Kissdental, I’d love to be able to expand the brand. I’ve always seen the brand as a national brand. I don’t believe it to be a local brand. I never set it up as a local brand. I think I’m at three clinics, and I have been at three clinics for near 10 years now. So I have the physical investment and energy to do that myself? I think the answers probably no.

Kailesh: I think moving forward the only reason I would want to consider whether it be a cell or whether it be energy, would be to look at being able to bring that brand two more locations to give more people the opportunity to have a piece of the Kissdental pie, and to really showcase what I believe is one of the strongest brands in UK dentistry.

Payman: If definitely is. It definitely is. And one of the pioneers. You got to look at it in the context of the time. It’s very easy now to look at Kissdental. Still a brilliant brand. And my brand I don’t mean logo. I think we all understand there’s a lot more to a brand than the logo.

Kailesh: Yeah. Exactly.

Payman: But the pioneering guys, when you guys did that back in when was it? 2005, ’06?

Kailesh: Yeah. 2005.

Payman: Back then it was pioneering thing to do. And brave, courageous thing to do. And your dad must be proud of the two of you, looking at what you’ve done in both directions, it really is marvellous. He must have done something right to make you two as determined in the different ways that you are, right? And for you, Kai, I think it’s a shame if anyone thinks that you’re, I don’t know, up yourself or something. Because you’re one of the sweetest, kindest people I’ve ever met.

Payman: You’re actually quite the opposite of that. You’re a very sweet, kind person. And maybe it’s the bravado, maybe it’s the cars and watches that make people think that this guy is… maybe it’s that. But you’re one of the loveliest guys around. And I’m sure you’re lovely to your staff, and I’m sure you’re lovely to your patients. And at the end of the day, of course you’re fast, but in keeping those different communities happy is what makes a successful person, and [crosstalk 01:19:42]-

Kailesh: Yeah. And I do genuinely believe that. I believe my business has grown, my core staff have always stayed. The majority of them anyway. I’ve got my managerial team who have been with me 10 years plus. People don’t stay if they’re unhappy, so I’m hoping we can carry that on and they can grow with the business and grow with me for the years to come. But your team, you will only be as successful as your team around you. And I do genuinely believe that.

Kailesh: And do I look after my staff more than probably some owners, business owners? Yeah. Of course I do. But they are part of my family, they are part of the Kissdental family. And anyone that’s worked for Kissdental, whether they are working for still now or they don’t anymore, I would hope would say that same thing that regardless of anything else, when I had my time there, it was a happy time because Kai did treat everyone hopefully with [crosstalk] level respect.

Payman: It’s a special atmospheric, Kissdental, for sure, man. Special atmosphere when I’ve been there for sure. Prav likes to end it. I don’t know, Kai, if you listen to this podcast or not, but Prav likes to end it with one [crosstalk] quick little question.

Kailesh: [crosstalk] Go on. Go on.

Prav: So our kid, imagine it’s your last day on the planet. Oh, a bit emotional. Imagine it’s your last day on the planet, you’re surrounded by your kids, what three pieces of advice would you give them?

Kailesh: Difficult sometimes, isn’t it? You think you’re the be all end all. I’m my little son’s hero. Just this year he got me for my 40th a little key chain and it had Iron Man on it. I suppose I know no one really sees me upset and stuff, so I try not to, but I would probably say to you that the one piece of information I’d way to say to them is know that everything that they do in life they should do for themselves and they should do because that’s what they genuinely believe.

Kailesh: I’ve always done things, and some things I’m not proud of, some things I’m super proud of, but I’ve made a lot of mistakes, but I’ve made loads of wins in life, as well. And I want them to know that not everything is going to be a win in life, but be true to themselves really. I don’t want them to be dentists just because their daddy’s a dentist or anything like that. And I’d tell them to try to save a bit of money not like their dad, and try to maybe not buy too many shoes.

Kailesh: And then, I suppose just to know that try and love. I think my biggest sometimes downfall is I’m just too openhearted, and I love a lot, and I trust a lot. And sometimes that really does bite me in the ass. But would I change myself? No. Do I still trust people openly and wholeheartedly, yeah I do. And I think if you lose that as a quality, you become quite bitter. And so I would say to them, always see the best in people. I always have. And it’s served me well to the majority of time that I’ve been on this planet. So I’d still stand by that.

Prav: And finally, how would you like to be remembered in one or two sentences, if you were to say, “That Kailesh Solanki, he was…”

Kailesh: A fun loving guy, life and soul of the party, especially at the MSN conferences. Hopefully everyone’s had a reasonably good experience with me when they’ve been out. I try to make friends wherever I go. So I just want to be known as the guy that is that fun loving person. But past that, he’s good at what he does as well. I’m not a businessman as the first and foremost thing. I’m a dentist, and I have a passion for what I do. And I love what I do. And I want to be known for that.

Kailesh: I don’t want people to think, “He ran a great business,” or “Kissdental made loads of money,” but as a dentist he was a bit shit. That’s not what I want to be known as, and it’s not what I’ve pushed time and time again to be better at because I want to be known as a good dentist, someone that has mentored many people, and someone that I think when I do go out and I do party, or socialise, that I’m one of the nice guys out there.

Payman: Well, Prav’s a blubbering mess.

Kailesh: I know.

Payman: For once Prav didn’t make our guest cry.

Kailesh: I was nearly there. I was nearly there.

Payman: Well, it’s been a real pleasure having you, buddy. And really, we could do a part two and part three. I don’t think we even scratched the surface. But-

Prav: Not even close.

Payman: Not even close. Not even close.

Prav: [crosstalk] Not even close.

Payman: I’m sure we will do it again. Thanks a lot for doing it, man.

Kailesh: No, it’s my pleasure. Thanks, guys.

Prav: Cheers, bro.

Payman: [crosstalk] Take care, buddy.

Kailesh: All right.

Payman: See you soon.

Kailesh: Speak to you later. Bye-bye, bye-bye.

Payman: See you, man.

Outro Voice: 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.

Prav: 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’ve had to say, and what our guest has had to say, because I’m assuming you got some value out of it.

Payman: 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.

Prav: And don’t forget our six star rating.