This week, Prav sits down to chat with implant dentist Dr Nadeem Zafar. 

Nadeem discusses how he spots potential greatness among implant students, reveals game-changing advice to his younger self and flirts with world domination at a fantasy dinner party to be remembered!

Enjoy! 

 

In This Episode

01.53 – Backstory

15.20 – Guy’s, VT and implants

27.26 – Blackbox thinking

33.06 – Talent spotting

37.45 – Advice to my younger self

39.10 – Last days and legacy

40.51 – Fantasy dinner party

 

About Nadeem Zafar

Nadeem Zafar graduated from Guy’s Hospital in 1994. In 2000, he went on to complete a master’s degree in implantology with the Eastman Institute before returning to Guy’s as a clinical tutor. He has also held associate professorships in universities in South America.

Nadeem is a former president of the Anglo-Asian Odontological Group.

The course I’ve got is designed for everyone to learn it very quickly and either do it yourself or you quickly learn that maybe you just don’t like surgery and it’s not for you. But being a dentist, even though implants isn’t taught well, undergraduate is up to each dentist to understand implants, how they work. Pros and cons of it. So at least you can refer your patient to the right person. Yeah, because your patients expect you as a dentist to understand it all. And if you don’t understand it, then they don’t think of you as a very good dentist, even though you might be brilliant at composites at Crowns That smile makeovers in that. But if you don’t understand anything about dentists, they don’t think you’re as good. So it’s important whether you end up doing implants or not. You should do a course with hands on, not just theory. You might find that you love doing the surgery or you might find you don’t. In which case you can just restore. Or you might say, Sod it, I just don’t want to touch it. But at least you’ve got some knowledge that you can give to the patient. So they still got confidence with you as a dentist, as being a competent dentist who knows things, even though it’s not necessarily your field.

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.

Kick the theme. Welcome to the Denver Leaders podcast. Thank you. And you know, like yesterday evening at the near down event, we were sat down on the same table. I think we even shared a pudding. Yeah.

And yeah, you want the good one.

And we just sat there and shot the breeze for a couple of hours, right? Yeah. You know, sometimes you connect with people, right? Well, whatever it is, the chemistry is there. And there are a lot of stories shared, and I want to try and capture some of those guys today. Yeah. I think one of the things that struck out, you know, that people like people like themselves, we’re both shopkeepers. That’s right. Yeah. So what I’d like to do is go straight back to your childhood. Right. Tell me where you were. Sort of brought up a little bit about your upbringing and tell me a few about the shopkeepers stories of being brought up in that environment and what that was like. Okay.

So I was brought up in Wembley, north west London. You know, had my father especially had worked himself up, I think he came into the UK in the fifties. He came to the UK basically just to earn money to give back home, because I think as he was growing up, he remembers having to borrow money to buy food, buy food and put it on the table and then taught like earning some money and paying it back. And he didn’t really like that. So for him, he actually came to the UK to to earn a living and send money back. And I think he always thought he would always go back home.

Well, his home.

Home is in Lahore in Pakistan, so he worked sort like all the hours in the day. He would he would study, he would do sometimes sort of like evening classes. He’d just find whatever jobs he could. He sums up be an usher in the theatre. I remember he used to sort of meet people like Charlton Heston and Gregory Peck, and he used to say to me how he used to meet them and and whatnot. But he was a really, really hard worker. Then later on, he had an operation. I think I was around about eight years old when he had an operation which went badly wrong. So he’s in the hospital for about a year. And I remember those really hard times because I couldn’t afford much. I remember thought I would be lucky to have one meal a day, and even when I went to school, I didn’t have any money to buy lunch. And if I ever got $0.10, it really meant a lot, right? That really meant a lot to me. And sometimes I wouldn’t want to spend it because I knew how hard it was to get the money those days. And then my father almost passed away because of what happened. And when he got regained his fitness and came back, he then had to figure out how to make some money for the family.

So that’s how they started the grocery store. And he built that up and mum, Dad really worked really hard. Their main thing was. At kids. We got a build a future for our kids, which is notable because they weren’t weren’t really thinking for themselves. I think our parents mind like yours. They think about their kids or what they’re going to provide for us, that we can become either doctors or lawyers or whatever it might be, because that’s what would make them proud. So I remember having to help them out in the shop and waking up at five in the morning, counting the papers newspaper. And I used to do the paper rounds as well, right. Especially on Sundays when they got this bloody big time newspaper. You can’t put the whole damn thing through the letterbox. Right. And I used to wish, you know, like in the States, remember, you know, they just throw them, right? Yeah. But no, we’ve got these little tiny boxes. I got to put this massive paper through the whole thing, you know? So I remember sort of hating to wake up in the morning, and I was only be doing paper rounds on weekends. And I know my parents will work in sort of like seven days a week. And the only day they kind of had off was Christmas Day.

But you just a quick question about the shop. Were you living nearby? Was the shop part of your home? What was the what was the setup? Well.

The set up was that we had in fact, they had two grocery stores. I had one at one point in time where it was like five, six miles away from where we lived. And then when they sold that and we moved out into Camberley, then we were living above the actual shop itself. But I really didn’t see my parents very much. I mean, you went to school and did things and they were just working full on. And I’d always wanted to be a football player. And I think my dad only ever saw me play once. But when he saw me, he was impressed, which really pleased me. But I wish he had seen me play more because those days, all I want to do was be a football player. That was it. So anyway, we had quite a hard life. We appreciate money and everything like that. And thanks to my parents, I became what I became, you know?

You know, I speak to people about the upbringing in the shop. Yeah. The learning, the art of hard work. Right. So. So I work incredibly hard, have done during my whole career. Right. But I still do not think that the hard work and effort that I put into my career even compares to what my dad was doing back in the day. I agree with you.

I agree. I mean, that’s real hard.

Work.

Now, most people think I’ll work really hard because. I have a few practices. Even when I do my normal 9 to 5. Let’s be honest where I eat food and then actually I’m on the computer or I’m brainstorming or I’m thinking about things. So technically, I’m probably working most of my day. But you know what? It’s so much fun. I don’t realise I’m working. Whereas when my parents will work, I know they really enjoy the work with hard labour. It was hard work, you know, throwing things around, going to cash and Carrie doing this, counting balls, counting the newspapers, returns and all the rest of it. And I think the other thing I probably learned from them was by working in such environment how to communicate with different types of people.

All right. Nail on the head, mate.

You know, I used to be really surprised how my father was. Really how cosy he could talk to anyone about anything. And it was more friendly with the gangsters that came in the store than anything else. And they ended up being his best mates. So I think inadvertently I didn’t realise it, but it probably taught me how to communicate, which helps me with my patients.

It’s really interesting you say that Payman, who’s a co host of this podcast, he always says that sort of mine and Kailash is, shall we say, part of our success is drawn from the fact that when we were in the shop we’d be serving everyone from your old day, your 85 year old ladies coming in for a milk and bread. Yeah, through to the young kids, the good for nothings, you know, and everyone in between, right? That’s right. And you just learn how to adapt and have different conversations with human beings and doing that from a very young age. Yeah. Muscle memory, right? Absolutely. Do you find the same?

Absolutely. You know, you can relate to people more easily. And it’s like, you know, when you see you know, for example, when Sir Alex Ferguson being a man United supporter. Yeah. And when Cantona came in, like you had to treat him different because he was different to the others and you can understand it. Whereas some people were like, well, why isn’t he the same with everyone? But you can’t.

Be.

You know, same with our staff. We’ve got to treat each person slightly differently in order to get the best out of them. So it’s understanding the psyche of who we’re dealing with.

And so fast forward and from there, you know, you’re brought up in the corner shop and whatnot. Fairly sort of unprivileged upbringing. Actually, one.

Thing I didn’t tell you.

Well.

That grocery store is my practice, right? So it’s my father’s dream. That I took over the I converted the grocery store into my practice. So he asked me. I was doing my master’s degree. And he friends and he was like, I want you to take over. And I said, You know what? I don’t want it. I want to go to the states. I want to study more. I had these dreams that I was going to work in central London as some hotshot specialist doing whatever. And life’s got a funny way of coming back around. So far, they’ve been working pretty much through almost 365 days for so many years. That his health wasn’t great. And when I said I didn’t want to take it on, they had almost sold it. And the day that the contracts were supposed to be signed, the other party didn’t come to the table. And it was it was heartbreaking because my mother and father had finally booked the holiday together, which they never had for over 20 years. So it’s heartbreaking to see that. And at that point, I was like. Okay, I’ll do it. So I took it on. And I guess my father really happy because that’s what he’d always wanted. I just looked at it as that, you know, maybe it’s just meant to be. Sometimes you think that’s your pathway as something happens and it just turns you into another direction.

Really interesting, because in a similar way, I still own the shop. Oh, really? Yeah. Funny, though, isn’t it? So when my dad gave it all up. Yeah, I bought it. And I still rent it out today. Right. To another shopkeeper. All right. He rents the shop. Yeah. And I have much to do with it. Yeah. Every now and then, I’ll go back live past. And it’s actually my dad today. He collects the rent. Right. Yeah. But it’s got history and nostalgia with it, you know? And I’m sure you’re stepping into your practice, and it’s. Well, that created this, right?

That’s right. That’s right. Well, obviously, you used to live upstairs, so it’s only recently we just finished doing a refurb. So we’ve added two more clinical rooms upstairs, which used to be our living room. And my parents bedroom and my bedrooms changed into a kitchen. So it’s nuts.

Yeah. It’s absolute madness. So from there, where is your career headed? So what were you like at school? We were swats. We were a bit of a jack, the lad, you know. What sort of grades did you need at that time? And. And you mentioned football earlier, right. We were you this wee this kid who was going to become a.

Supposed to be the next.

Star.

And I really believe that had I not had the injuries, I would have been a top player because I just loved playing with the football. I didn’t need anyone with me, but I just love football. And if you’d asked me what I want to do, I’ll just say I want just to play football. But obviously, as I got older, starting to get sort of problems without my my knees and my ankles and I couldn’t finish games. So. It was a good thing my father instilled in me from before. Yeah, you can be a sportsman if you like, but educate yourself at the same time. So in effect, I had a fallback plan in a way, so. I still didn’t know what I wanted to do. And just so happen that I like to go. And she wanted to be a doctor. And she said to me, Well, I know you want to do Spore and that why don’t you be a dentist? So my reaction was. Dennis Yeah, I can’t see myself looking in patients mouths all day as you go. No, no, no. Look at you as a business.

How old would you? I will do you then do.

C 1516.

So what? This was a young sort of. Yeah. Childhood crush sort of, Yeah. Special relationship or. Yeah.

First kiss you’d say Yeah.

Yeah.

And then she mentioned about dentistry and then it made sense. Because she would say, Well, you can be your own boss just working many days as you like. And if you’re still in sport, you do sport most of the time, do one or two days there, make a little bit of money because back in the day, sportsmen didn’t make much money. Your career was also short, so probably that was best advice I was ever given. And obviously I was tempted because she said, Well, I’ll I’ll be at medical school as well. We’ll be there together.

But she’d mapped out the dream.

Yeah, she’d mapped out the dream. And then when I got there, then, then that was it. She went her way and I went my way. But it set me on the pathway. And I think it was also good because it sort like pleased my parents as well, because, as you know, they want a doctor or a dentist, a lawyer in the family. So it suited them. Medicine was something I’d never would have touched anyway, because I don’t like to be on call 24 seven. And the life of a doctor doesn’t really suit me.

Yeah.

So yeah, it was it all worked out in the end.

And so where did you go to dental school?

Hospital. London, which was my first choice. I was so happy to get there.

Everyone who goes to go says it’s the best. Yeah. Why is that? Just because it’s a snob factor. It’s not. It’s a.

Snobby thing, let’s put it that way. And we love to be snobby that we were. All right. So a load of BS. But guys, people are the best.

So yeah.

It was, it was nice to be there because honest, if I’m honest with you, I didn’t think I’d get into dental school anyway.

Why?

Because I wasn’t. I wasn’t the best student. I’m thinking about my next football game or something else. I, I wasn’t the best student, to be honest. The time when I became the best student was after I qualified. After I qualified, and when life became a little bit more serious. Because now you’ve got to pay for your mortgage, you got family and all the rest of it. Now it’s like, okay, now I really need to perfect my craft. Whereas before it was just a case of, Well, I just got to get past this. Let’s just get past that because not like industry don’t have sort of like first class, second class to 1 to 2 just pass fail or honours right now. Wasn’t going to be an honest student because I enjoy life too much. Yeah. So it was just about just getting through.

Got you. What are you fondest memories of dental school or that era.

Diwali.

Shows. Yeah.

Going to going to out with the friends partying. Don’t remember too much of the studying side of things, to be honest with you. But is this social element just mix in with lots of different people and those lucky to have a really fun group of people as well. So that was great.

So you qualified? Yeah. First job.

First job vocational training.

In Ilford.

In Essex. It was all right. I can’t say I loved it. I think I always felt there was something more out there for me. Interestingly enough, when I qualified, people were just talking about implants and I remember the professors at university, there’d be the odd one who’s just done his first implant or something and it’d be really excited about it. And I was like, You know what? I really like to do that because I can see a need, because there’s the thing is, you don’t have that many specialities in dentistry, so you go orthodontic orthodontics, okay, moving teeth. It’s not to me, it’s not very exciting. Then you got root canals. Everyone hates having root canals. Then don’t fancy that one either. Perio period is like an invisible disease that most patients don’t even know. They’ve got it. And their arms give me thousands of pounds and I’m just going to clean a few bacteria. But they’re never going to go and you’re still going to lose your teeth.

And then There’s no disrespect to the periodontal. No.

No, Sorry, sorry, sorry. But for me, implants were straightforward. You’ve got a missing tooth that’s replace it. Yeah. And so that really attracted.

Me early on in your career. Yeah. Yeah.

And I think it was because no one else was thinking in those lines as well. But it was something I always wanted to do. And then they came out with a master’s degree in implant ology at the Eastman’s that I really wanted to get involved in that, and I was lucky enough to be given the chance to do it. So for that, I’m really, really grateful.

For that, though, didn’t you? It wasn’t easy to I don’t mean easy to get on, but there were certain circumstances in your life that you made some decision. Hard decisions, right? What were they?

It was hard. I guess what happened was I had applied, I think it was in 98, I applied to do the master’s degree in implants. At that time, my daughter was born in 98. My son was going to be born in 99. At the same time was the time that I said to my father, I take over the business and turn it into a practice. And I just bought a house. And I jokingly said to some friends and I said, You know what? The funniest thing that will happen now is if they offer me a place on the master’s degree because I’m kind of maxed out with everything. If they offer it to me, I know what to do, because financially I’ve just got these the house and the practice to make. How can I do a full time course? Anyway, I thought, well, figure out if it ever happens and. I think someone who is already on the master’s degree course who was earmarked to start it, had to pull it out. So one space was left and they called me. So I think they called me around end of July and the course starts in September. And my accountant said, No, you can’t afford to do it. If you can delay it, delay it. But now you can’t afford to to do all the things that you’re doing. Which made my missus a little bit worried that what’s going to happen if we can’t afford anything. And then I spoke to my mentor and wonderful guy, Tommy Datta, who is ex president of AOG. And he said to me, Look, education. Is great. If that’s what you want to do. Forget about the money. Just do.

It.

Is going to help you later on. Don’t listen to anyone else. You want to do it? Do it. Don’t worry. And I think he was one of the very few people that supported me to do it. And I was like, Let’s do it then. So I went for it. So it was it was a really hard year trying to do it. And I think that’s what also led me to make my courses because I had to take a lot of time out. It cost me a hell of a lot of money. Because they still had to pay for everything. Another thing that happened was while I was trying to make the practice, my architect ran off with my money. And then I was quite good at graphical design. So I actually did all the technical drawings because I had to do change of use and everything. And I had to submit the applications for that. And then I did all the decoration myself at the practice while I was studying, you know, five days a week at the Eastman’s. So it was hard. And plus, you know, with a two year old and a one year old and the practice wasn’t close to my house. My house was in Wembley. So I bought a place back in Wembley and my practice in Camberley an hour away. So there was a journey involved as well. But they all worked out in the end.

Moving on that journey from, shall we say, doing your MSC. And you mentioned that you had this certificate, but it didn’t give you the hand skills, right? Which is sort of part of your motivation. How did you get the the practical skills for implant dentistry?

Difficult. It was really.

Hard. I think one.

Of the things was I did get a handful of patients come in and they wanted treatment. And in a way, I kind of felt like I’m an actor and I’m on stage. Because even though your heart’s beating that you think I don’t know really what I’m doing. I’ve read all the theory. I know it. But I haven’t had that much experience in front of the patient. I can’t be like that. I’ve got to say yes. I’ve got to talk it up. I’ve got obviously tell them the pros and cons of it. But if I’m your dentist, you have to have confidence in me. So I can’t give you any of my question marks and bubbles that are up here. So that was interesting. But it led me to want to go fast, track myself, to learn as much as I can. So I kind of travelled the world. I met up with some of the top speakers at the time and tried to shadow people, trying to learn techniques and looking at the finer details of things and doing some courses just to get some one or two hands on courses as well. So it took me a while to pick up the skill. And the other thing I felt was at the beginning, when you’re doing implants, you need to know somebody behind you that if you made a mistake, someone can support you.

Yeah.

And once I’d done my master’s degree, I wasn’t so sure I had that support. So it makes you a little bit more anxious because when you’re doing surgery, we’re taught to deal with teeth, and now you’re talking about bone and nerves and the sinus and things like that, things that actually you probably don’t know as well as you should do. So you can get a little bit too apprehensive about things, but if you’ve got a backup, it can fill you up with a little bit of confidence and it makes it easier. So having gone through what I went through, that’s why I made the courses so that you could work at your practice. Not take too much time off and still get more hands on in my course than you thought you would on a masters degree. Not to say that you shouldn’t go and get a masters degree. So I’ve had quite a number of delegates who’ve done my course. Started to do more implants, which was great because now they’re starting to pay the money back and starting to earn money off what they learned from me enough that they can now pay to do a part time master’s degree. But the benefit of that is now they understand what they’re being taught at the master’s degree. Because unless you’ve done surgery, you don’t understand what the other professors are teaching you because you’ve never done it.

Yeah.

Because the feedback I got from my past delegates who ended up with master’s degrees was that 90% of the delegates hadn’t placed implants, but they’re on the master’s degree. And obviously I went on my master’s degree with with very minimal knowledge as well. So probably a lot of things went over my head. Now, I didn’t catch anything. It’s only when I start to practice that the small details become really important, which you probably missed in your lectures.

Yeah.

So lots of people who went and done their master’s degree with no knowledge didn’t complete. Or if they completed it, they didn’t have the hands on skills. So I’d say to anyone who wants to start out in implants, I think the course I’ve got is designed for everyone to learn it very quickly and either do it yourself or you quickly learn that maybe you just don’t like surgery and it’s not for you. But being a dentist, even though implants isn’t taught well, undergraduate is up to each dentist to understand implants, how they work. Pros and cons of it. So at least you can refer your patient to the right person. Yeah, because your patients expect you as a dentist to understand it all. And if you don’t understand it, then they don’t think of you as a very good dentist, even though you might be brilliant at composites at Crowns That smile makeovers in that. But if you don’t understand anything about dentists, they don’t think you’re as good. Because I get that all the time. When I get patients who self refer to myself as they just haven’t got the confidence in the dentists or the team because they know nothing about implants. And the patient seems to know more than what they know. So it’s important whether you end up doing implants or not, you should do a course with hands on, not just theory. You might find that you love doing the surgery or you might find you don’t, in which case you can just restore.

Or.

You might say, Sod it, I just don’t want to touch it. But at least you’ve got some knowledge that you can give to the patient. So they still got confidence with you as a dentist, as being a competent dentist who knows things, even though it’s not necessarily your field.

You touched upon mistakes earlier and it’s how we all learn. We all make mistakes. Right. And I don’t think you heard the concept of black box thinking. We borrow it from the airline industry where there’s a there’s a black box right in every aeroplane, right? Yeah. And it records everything the good, the bad and the ugly and any of the bad stuff is shared industrywide. Right. And that’s why flying safety is what it is today, because they’re open and they share not just if BA’s flying, they’ll share it with everyone else and so on and so forth across the industry. But in medicine, it’s very good at sweeping things under the carpet and covering things up. And if we took that same approach in health care, I think we’d be light years ahead.

Yeah, I. I partially agree with you, and I partially don’t. Let’s put it like this. Docs and dentists ought to be competent enough that any error is within a range that isn’t critical.

Right? Yeah.

And things sometimes go wrong. Like I said to you before. I might have had a rough night and maybe my surgery wasn’t as done as well as on a different day.

Or you didn’t have your three Weetabix in the morning.

Exactly. Exactly. You know, so as long as and this is, I think, an important thing, I like to think that my course teachers, they even if let’s say you don’t do anything perfect, you’re within a range that the patient won’t realise that it’s not perfect. Yeah. Because the outcome looks good.

Fine. Right. Yeah.

And so if medicine could be like that, because the biggest worry is if you start getting people scared of doctors and dentists. Everyone’s going to be too scared to do surgeries for patients. Patients are going to be too scared to see the doctor. So there’s got to be a little bit of protection at the same time. But there has to be reflection by dentists and doctors as to what they’ve done. So on our courses, we very much also go into complications and how to avoid it, right? Because it’s important to have that understanding what can go wrong and how to avoid things and minimise those issues. So because also don’t forget when you’re flying a plane, you’ve got hundreds of people on board.

And life or death.

And it’s life or death, at least in this situation. Hopefully it’s not a life or death situation. It might be that cosmetically the tooth not perfect in the implant field, sure, but hopefully we can rectify it.

But on the whole, if I were if you were to take all the mistakes you’ve ever made, multiply it by every surgeon, and that gets incorporated into the teaching, the learning, the protocols, maybe we’d advance better. Who knows? But my question. Have you ever had an oh shit moment where you’ve been in a patient’s mouth and you think. What have I done? Where you’ve made that mistake. Error, whatever it is, whether you liked experience, dropped an implant in a sinus and had to fish it out.

Okay. The reason why you see my eyes roll all over the place is you downloads.

Yeah.

But it’s because I’m a perfectionist. Because after I do something and I analyse it. I’m quite critical and I’m hard on myself. Because that’s the only way to grow. So if it’s not quite right, even though no one else can see it, I don’t like it. So I’d like to say that probably on most cases, it’s seldom that I think, you know what? That’s perfect. Quite often. Okay, it’s not bad, but it could be better. Or maybe I could have done this. So I think reviewing your own work and being harsh on yourself is probably the best way to be. And then to be able to teach what you’ve learned to others so that they can learn from your mistakes. But also, it’s important that they also everyone makes their mistakes, but as I said, within a limit.

So your moment, do you as a student, younger dentist or whatever, is there any stories you can tell me? Any moments where you thought, bloody hell, I’ve dropped the implant and I’ve pulled the wrong tooth out? Anything like that where you’ve had to go back to the patients? I’m really sorry this has happened. I’m going to swear it away. No, no, no.

I mean, not that comes to my mind, to be honest with you. I’ve been frustrated where I thought I could get an implant. In the end, I couldn’t do it. But with implants. It’s not life and death. Wait three months, we’ll try it again. I think in the implant field, it’s knowing where your limitations are, but when it doesn’t quite work out on the day, just tell the patient and happen. But it’s not the end of the world. We can come back and try it again. So I think in the implant world, it’s it’s relatively forgiving if you understand what you’re doing. So. No, I’m sure I’ll think of something later on.

That’s fine. We’ll come back to it if you do. Just in terms of teacher. Obviously, you’ve had hundreds of delegates through your program now. Can you pick winners? Can you spot the good students and look good? Do you know the ones who you know are going to be successful?

It’s really interesting because. Once you start to make contact with people who want to do your course once they’ve signed up, I always try to, in my mind, think, okay, where do I think this person is going to be even I don’t know them. You just I just find it interesting. It’s also, you know, okay, where do I think this person is going to be on a scale of 1 to 10? Then when we start the courses and the lectures start, then I say, Well, why am I changing my grade or what? And then once they’ve done the surgery again, analyse it. To be honest with you, you’ll always get surprises because sometimes the person who I think is going to be the absolute best, who ask the most questions, sensible questions, and you think, you know what, This guy really knows this stuff. A lot of times they can’t do surgeries, you know, their hands not in it, or they can’t spatially see what they’re doing wrong.

All right.

And then you’ve got other people who you think, you know what? He hasn’t got it, but he’s got drive to make it. He’ll make it. So it’s really about how much passion and drive that you’ve got to want it. So I’ve seen some people, I think, gosh, that person’s got no hope. They finish the course and out of that group, they’ve done more implants than anyone else. So in a way, it kind of teaches me not to judge. My first instinct is you’ve got to give everyone a chance. But it’s still a fun game to play.

So in terms of the ones who have been super successful, what is it? What are the key ingredients if you are looking for somebody? Is it the ones with the drive? Is it the ones who are just really good with their hands? Is it the ones who’ve got the earlier? You mentioned that back, right In the early days, when you’re doing your first few implants, you put on this actor’s face. Right. And it reminds me of the conversation I had with my brother when he placed his first implant. He rings me up because I’ve just placed my first implant. I said, Oh, well done. How did that go? He goes, Well, the old dear, As you sat back in the chair, she looked back at me. And she said. How many of these have you done? And he said, I look too straight in the eye and said, I’ve lost count. Look. And that was his answer. But it was that bullish confidence that gave her the confidence for him to then go and do that. Right. So what is it about the students? Is it that is it the the rapport you build with the patient? Is it the hand-eye coordination spatial thing?

You can break it down into lots of parts, but I think the most consistent thing is that they have to understand it’s the beginning of their implant journey and they have to have the drive to keep studying, to keep coming to meetings like this, meeting like we’re at today. Yeah. And to be honest, when we have meetings like this, sometimes we learn more from talking to each other, exchanging ideas, you know, over lunch, over dinner. And that’s where you get a lot of the learning. So those people who keep doing courses continue. Education and implants are the ones that do really well. The ones who don’t like, like they stop. Some of them do, okay. But they’re not really going to end up doing loads and loads of implants. So for example, I’ve got, you know, a couple of my top students is Imran and Wes, who did my course. And the thing they had in common was drive one too. They weren’t necessarily the most gifted when they started. So if I were to sort like grade them in the group, they may not have been the best, but they were critical. They would always ask question, How can I improve? How is this one invalidation for what they’ve done and looking at things critically. But more than that, they really wanted to be involved in implants. And you have to have that attitude because like with any industry, things move on and you can’t stay with the old knowledge because what I taught ten years ago, many, many things probably aren’t correct today. So you have to think of it as the beginning of a longer journey.

Yeah. Well, one of the questions that we often ask in this podcast is just giving advice to your younger self. If you if you looked back and reflected on on your life and you could do it all over again, would you do anything differently?

No, I wouldn’t change anything.

Why? I think.

So now I just got a positive mindset and I think that kind of comes from my sports side as well. And. There’s no regrets on anything that I’ve done. I’ve always tried to make the right decisions, although sometimes they might be wrong decisions, but you realise it afterwards. But sometimes wrong decisions can lead to better decisions later on in life. Because, as I said, unless you make some mistakes, you can’t grow. So it’s just part of life. I’m I feel really fortunate to be in the position that I am. And it’s nice also sort like to come to these events and the people I’ve taught still remember and thank me for putting them on this pathway and how they’re doing well and things like that. And it’s just also nice to hear good things from patients and stuff. So I don’t have any I don’t have any regrets other than that I didn’t become a football player.

And the last day on the planet, you’re with your kids and your loved ones and you’ve got to leave them with three pieces of a life advice. What would they be?

Have fun.

Do you?

And what else would it be? Just enjoy the journey. Don’t get caught up in material things because you can’t take all these material things with you. But if you enjoy your life and have fun, I think that means a lot more and you’ll touch a lot more people. And it’s not taking life too serious. I remember a story someone told me about. They had a patient who was a really hard grafter and he wanted to be a millionaire by his mid forties. So all he ever did was work. So he got into his mid-forties. He’s reached his.

Target.

But now he’s got cancer and doctors giving him five years. But he didn’t enjoy his life. You don’t know what’s happening to tomorrow, so enjoy today and be thankful for tomorrow. So and I think that’s the way to live your life.

Yeah, well. The theme was the finish the sentence.

I can’t say what I want to say.

It’s too rude to say it.

The is the coolest motherfucker you’ll ever meet.

Wicked.

Peace. And I’m out of here.

Brilliant, brilliant, brilliant, brilliant. And one final question. Fantasy dinner party. Yeah. Three people dead are alive. Who would they be?

Three hot women.

Particular was.

Not that I can think of from the top of my head.

No.

No. But on a serious point, if I was going to. Yeah. Genghis Khan. And Alexander the Great.

And. I don’t know. Maybe.

Rameses. Pharaoh. Rameses.

It’s been an absolute pleasure, buddy. Thanks a lot. Thank you. It’s been great and an absolute pleasure.

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.

Thanks for listening, guys. If you got this file, you must have listened to the whole thing.

And just a.

Huge thank you both from me and pay for actually sticking through and listening to what we had to say and what our guest has had to say, because I’m assuming you got some value out of it. If you did get some value out of it, think about subscribing and if you would share this with a friend who you think might get some value out of it too. Thank you so, so, so much for listening. Thanks. And don’t forget our six star rating.

 

Recorded at a Neodent community event in late 2021, this week’s podcast sees Prav sit down with Brazillian implant impresario Sérgio Bernardes.

The pair discuss Sérgio’s route into implantology after being talked out of life as an equestrian vet.

Sérgio chats about his continuing love of horse riding, the legal landscape in Brazil and how the opportunity of a lifetime led to his role in product development at Neodent. 

 

In This Episode

01.33 – Entering implantology

07.53 – Zirconia implants

13.52 – Backstory

19.22 – Dental school

22.24 – Neodent

28.44 – Legal landscape

31.26 – Blackbox thinking

38.28 – Advice to new implant dentists

42.37 – Last days and legacy

44.51 – Fantasy dinner party

 

About Sérgio Rocha Bernardes

Prof. Dr Sérgio Rocha Bernardes earned a BDS from the Federal University of Rio de Janeiro in Brazil. He gained specialist status in dental prosthesis and implantology at the APCD/Bauru in São Paulo and the Federal Dental Council, respectively.

He also holds an MSc in Oral Rehabilitation from the Federal University of Uberlandia, and a  PhD in Oral Rehabilitation from São Paulo University/FORP, Brazil, with collaborative research at the Eastman Dental Institute, London. 

Sérgio has published books on implants, immediate loading, guided surgery and prosthesis. 

He is a professor a the Latin American Institute of Dental Research and Education in Brazil and the head of new product development and clinical practice at Neodent.

One surgery. Then I opened the patient and I had anatomy in my mind and it was, Oh, so this is that bone. This is the way the root is. Here is where we have the muscles attachments. So when you start to apply the basics on your practice and you are thinking during the surgery, this is really important because in the beginning you are only afraid acting on the defence. But when you study and you apply the basics on your patients, practice on your practice with the patient, then you feel confident and you know what you are doing. So immunology requires a lot of basic studies and then be prepared, be prepared to do courses because you need to finish your dental school and to make it in patients, you need to do clinical practice. It’s not only about doing a one way course, make any plans in the plastic job and you believe you’re ready. No, no, it doesn’t work like that. You need to do courses and you need to do courses in patients. So we need you to practical education.

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.

Sergio, welcome to the latest podcast. We’re here today at the Near Community event, which you’ve been presenting at some of the latest innovations with near event and the latest research. But let’s push that to one side for now and tell me about your backstory. So introduce yourself. And actually just to give the listeners some perspective. What volume of implants have you placed over your career?

Oh, okay. Well, I’m Brazilian. Like I said, I’m not really from Rio de Janeiro, and it’s where I graduated in dentistry, where I have my family or my parents. But then about 15 years ago, I moved to Korea, to the south of Brazil, where we have people in the And the reason why I decided to move was because of work. I noticed that the place where I work nowadays, it’s a very nice environment for innovation and developing products. When I finished dentistry, I remember that I did a promise and my promise was to look after the patients. And then when I was started practising, I don’t know, I felt like if I could become a professor or if I could turn to a trainer, or if I could lecture instead of me only helping patients. The promise that I’ve done when I graduated on looking after the patient, I could multiply it in other hands. So I was really motivated and inspired by becoming a professor or trainer and a lecturer and going to the academic world. So that’s why I decided to do the mastering in my Ph.D. And then when I started to train people and they could multiply.

The reason why I was doing dentistry, which was basically to look after the patients. I thought that if I started to develop new solutions, I could even help other professors and other trainers to help more people and then to help more people. And that’s when Amir then came to my life. And, you know, in the beginning I was working for education in Odense, so I was responsible for international education. So all academic work, you know, like doing manuals, literature review, preparing presentations and stuff like that. And but I was really close to the development team, and my dream was to work on the product development. And it took me some years to be confident enough and to work in a group in an environment where we have much more engineering than dentists. But I would say that now I love what I do. I love to create solutions, to create innovation, to create new products, because I believe that like that and helping more and more people. And the reason why I do my work is just because of the patients basically is this.

And so if you were to split up your time and just give us an insight into your world, how much of your time do you spend actually putting implants in patients mouths versus working on product development versus, you know, red tape and paperwork and all the rest of it? Just describe your your job, right?

Well, I graduated and reunited eight and at that time was extremely expensive to do in ontology. Basically, when I graduated, I was a dentist in the in the Brazilian army. And I had to make a decision or I would buy a car or I could buy a surgical motor and and a surgical cassette and do a course on ontology. And then I decided to use public transport and I invested my money. At that time it was really expensive on immunology. So in 1999 I did my first implant and then I started working as immunologists because in Brazil we have this as a field of dentistry, as perio or endo. So implant is something local. Yeah, is this is a special thing in my country. So I turned to an implant allergies just and then I decided to do the master and that was always clinically driven so I never liked to do only in vitro research. I always like to do some research where I could see results, you know, and tangible results. And so from 99 to 2006, I was sharing my private practice with this courses on immunology. And then in 2007 I was doing my PhD in and I came to the UK and I stayed one year at Eastman where. Fortunately, I couldn’t practice because of no license and stuff like that. But then in the UK, in Nisman, I met Dr. Zafar and that’s when I did my first international lecture for his courses. And then I started to see a common There is more war. The world is much bigger than I thought. And then this one year I couldn’t see patients, but at least I could see different.

People pass the knowledge.

Yeah. Personal knowledge meant and met new friends. And then when I come back to Brazil, I keep practising in Brazil nowadays because I share my practice with product development. I only work as a clinician twice a week, Tuesday and Thursday. And as an average, we make like 500 implants per year. Because I don’t do any other work on dentistry, I only do implants or prostheses with implants or sometimes procedures to spawn. But mainly it’s in ontology.

So in those two days you’re placing 500 implants across the year. Yeah, exactly.

They do a lot of large. Yeah, we do a lot of large. So then the numbers tend to go up. And like I said, I don’t do any other things and I don’t do wisdom teeth anymore.

I just throw in metal rods in people’s heads and zirconia. All right. Okay. Okay. Yeah. And how many how many zirconia do.

All the ceramic implants are doing? Really well. I see it. I don’t see this as a substitute of titanium steel. I see this as a new option. And another two or maybe another technique or another solution we can offer to the patients. I also don’t see that ZIRCONIA implants are not for a niche of patients like the patients that don’t want metal in the body. I don’t see like that.

Okay.

I believe that ceramic implants are for has three basic indications. Number one, patients nowadays, they are no longer patients. They are health consumers. And so when they Google implants ology, they will look after, you know, grafting procedures, the treatment planning. So they have a lot of information on that. And also they can see what implants and for sure, the patients perceptions on aesthetics, it’s much higher when they see a white implant instead of metal implant.

Even if you never see that implant in the mouth. Right.

That’s true. That’s true. Yeah. It’s about the patient’s perception. So I believe that at the moment they start Googling it and they will see what implants. Well, they will ask for this for us. Also, there is another problem we have nowadays about periodontitis. And in that, well, in the literature, we can see that ceramic implants, they have less biofilm adhesion when compared to Titan and implants. So in cases of poor implant itis patients that has already periodontitis. Maybe that would be an implant that makes the patient’s life easier to keep a good hygiene.

Got you.

So for me, it’s about patients perceptions on aesthetics, less biofilm adhesion. And the third one, it’s about the soft tissue relation as well. Ceramic material has a much better adhesion of the junction epithelium. So from the biological point of view, it’s amazing the results we have from the soft tissue when it comes to zirconia compared to titanium.

And then with respect to comparing zirconia to titanium, is there any sort of studies in terms of longevity or strength or anything like that? What are the differences?

Well, for sure, it’s work with ceramic implants is completely different than to work with metal implants. With titanium implants, it’s like, you know, when we used to do bridges with a metal framework at the moment, we started working with metal free bridges, The way we practice, the way we try, the way we work has to be different. So we need to understand that titanium is different than zirconia, and we need to respect those differences. So for example, when you replacing it as a implant, you need to respect the osteotomy if you want the size too much and if you have talks over 16 centimetres, you can put yourself in trouble. So you need to respect osteotomy. Also when it comes to zirconia, we need to have in our mind that the design of the implant has to be different because the material is different. So we need to trust in the industry that did the correct research and for us. For example, we spend about five years developing this product because we were finding the perfect design for zirconia, which is a different design than when you design an implant made on titanium. So we need to trust in that and understand that different words.

And so how many non titanium implants have you placed in patients.

And lapel on the school? We placed already about 300.

Oh, wow.

We’ve been following following up with other colleagues, about 500 in the last five years. And the doctor told me and my boss and I, we did together about 200 implants and we have follow up for about five years. We’re not only doing this in the end of the day, we only have solution for singles between pre molars. And so that’s why in this five years, we only placed this 200 implants.

There’s still a lot, right? You’re following them up. And have you any patterns in terms of bone loss or longevity or anything like that, these early stages?

Well, in terms of bone loss seems really similar to titanium implants. In terms of soft tissue, it’s amazing. We can see soft tissue growth. I never did a research on animal research or preclinical research on the soft tissue level with cornea implants. I would like to I would love to do we already done in Minipigs, but we are making analysis on the Austin integration. So the Hospital for Medical analysis we’ve done was comparing in the same animals replacing one side zirconia and the other side like a splinted mouse titanium. And then we placed implants. We wait for the regeneration and then we did a hostile mathematical analysis and we proved there is no difference between silicone and titanium on the bone level. So the bone biology is exactly the same, but for soft tissue, I never did this in animal. But from the clinical research we’ve been conducting, it looks to us that all the research we read about it is true. The soft tissue has a very good reaction when compared to titanium.

So if we step right back now, said Joe, tell us about your childhood, where you grew up, what it was like growing up in Brazil and your parents as well. So how did you get into the career? So so go back to your childhood. Tell us about that. Brothers, sisters, siblings. What was all that like?

Yeah, well, Brazil is a huge is a huge country. Brazil is a huge country. And I was born in Rio, but my father is a military, and so I spend most of my childhood in a military base, which is is nice. I could play in the street was everything was safe. And also we I mean, I would say 90%, 80% of my time we lived in Rio, but I lived also in the countryside of Brazil. Once we lived in the area in the central Brazil, closer to Paraguay, it’s closer to a big force we have in Brazil because we have Amazon and then we have this area called Pantanal. And so I lived in this place when I was six years old, seven and I have memories from that time. And when we come back to Rio, I started writing horses since I was seven, right? Yeah, maybe because of the countryside, I don’t know. And so my my childhood was basically going to jump with the horses and then, well, going to the beach, enjoying the beach, the nice weather of Rio and sometimes studying. Sometimes you need to.

Study every now and then. Yeah. Yeah. And so what were you like at school? You were a smart student was to get into dentistry. If you’ve got to be a certain standard there and just tell us about it.

Because of the horses, my dream was to become a vet.

How interesting.

Yeah, because of the horses. I would like to become a vet. And that was jumping and that was good about on the sport. And I said, okay, you know what? We become a veterinary. And then I would work only with horses. And then my father came to me and maybe different than nowadays. My father said, You know what, Sergio? If you want to become a vet because you like horses, that’s not the correct way. You shouldn’t work. On things that you, you know, really appreciate it. This is your hobby. You shouldn’t work for your hobby. He said.

Okay.

You should work in something that can sustain your hobby. And horses are extremely expensive. So you need to do something that could sustain your hobby. And I said, okay, you know what? I like biology. And then I said, Okay, maybe if I become a dentist, I could try to do that. And then I did dentistry.

So it’s not just a random thought. Did someone push you to dentist anyone in the family? No, nothing like that.

Zero. No one in the family was. And then I start from scratch and it was basically because of the horses. And then. But then it took me, Oh, wow, 24 years. Because when I started doing dentistry, I by the way, one of another reason why I decided to dentistry and not to become a physical doctor, a medical doctor, was because of dentistry. It’s like four or five years. And if I become a medical doctor, it’s like five, six, sometimes seven. I said, No, I don’t want to spend my whole time in the university. But then I did dentistry, I did specialisation, I did master, I did a P.S..

And now you’re back in the university. Yeah.

So it’s been my whole life studying. And then I quit. I had to stop with the horses because, yeah, I fell in love in the industry.

When did you quit the horses?

It was 2002. And after 20 years, now I’m back with the horses. Yeah. So after 20 years, I finally managed to do this. Amazing. I’m not rich, you know, But, you know, I’m capable to keep the horse. So it’s. It’s fun and it’s fun to to back. To be back on on on this.

And the you as passionate about that hobby today as you were as a kid.

Yes, that’s true. So basically today I wake up five in the morning to go and see the horses from 6 to 7 and then from seven I take a shower and I go to the clinic. So that’s what I do in the mornings. So every Monday, Wednesday and Friday I go to the horses. Every Tuesday and Thursday I go for running. And then Saturday and Sunday I do both.

And so when you say you go to the horses, what do you do? You ride them in a field, you jump with the jumping. Yeah. Yeah. And is that competitions involved in that. Yes. Do you partake in them.

Well, this year I was, I was the winner of the state championship of Para Now where we’re.

Olivia. Congratulations.

Yes, I’m a state champion right now.

Wow. Wow. And so with the. Because you took a break from the from the horse thing, right? And then you come back. How long was that hiatus? How long was that break?

It was 20 years.

And 20 years later, you come back and win the state championship.

It’s like cycling. Yeah.

You never muscle memory. Yes, exactly. Exactly. Wow. Wow. That’s amazing. And so. Okay, so fast forward, you go into dental school. What is dental school like in Brazil?

Well, in Brazil, I’ve been to the Rio de Janeiro Federal School. So it was a public school. And at that time now this is about five years. At that time it was four years. And basically the two first years we do the basic. So we do anatomy physiology. Exactly. All the basic stuff. And then the last two years, we go to every special field. And then the last year we have what we call is like a general practice. So in the last year you spend one year just seeing patients and doing a little bit of everything. But in Brazil, when you graduated in dentistry, if you want to advertise a special field, you need to do what we call specialisation. Specialisation is a kind of a course between a graduation and the master, and this specialisation is just a clinically driven course. So you don’t need to write a big paper, you just need a monograph fee with a literature review, something similar, but you need to see patients doing two years, so you need to see patients and treat patients. And when I finished dentistry, I did my specialisation on orthodontics and the reason why I did X is because the first department on my school wasn’t that good. And I felt like, okay, you know, I know I do specialisation and approach to doing X and then I go to the to my practice. When I did President X, We are starting to do implants in Brazil. So I said, okay, I’m doing precedent, so I need to understand how to do prosthetics for implants. And when I started doing prosthetic for implants, I said, You know what? I think I need to do surgery of this. And then I did a course for surgery with implants, just replace one or two. And then I said, oh, no, you know, I think I need to do something for grafting now because I went to delivery everything for my patient.

So when you did the implant course, we were like, This is what I want to do. Yeah, this is my thing. You fall in love with implant dentistry at that point.

Yeah, definitely. When I was in the dental school, I was. I mean, I really liked anatomy or anatomy and I really enjoyed surgery. So I was as a GP, I was doing with wisdom teeth, for example, reason tooth on the practice. So I was really comfortable about surgeries and then I decided to do prosthetics because I was missing this learning. And then when I did Info ontology is where I could see, you know, the two things that I was falling in love, like the prosthetics and the surgery. Combine it in one technique. So that’s why I fell in love with ontology. And like I said, nowadays I only do implants.

Amazing. And how did you get involved in the product development near what, like you went from riding horses to saying, I need to pay for my horses, so now I’m going to do some dentistry to pay for my horses and you got, you got this place to, you know, you did the specialisation and then from here you found yourself in a position where you are involved in research and product development for any then with the founder, creator of Near Dental. How did that opportunity even come about?

That’s a nice story because I would say I could say that I was lucky. Basically when I was doing my master, I was doing my research on bioengineering, so I was doing photo elasticity in order to understand the stress fields around the implants with different connections. In order to make the photo elasticity analysis, I need a company to produce special implants to place on the raising to make them that analysis. And well, in Brazil we have some local producers. And then on the school that I was doing, my master at Dr. Tommy, my mentor nowadays in my boss, he’s the founder of Neo. Then he went to the school to do a live surgery and then I had my project, my hands. I was a masters student and I came to him and I said, Hey, could you could you produce those implants for me? And he said, Why? And explain it to him. And he said, Yes, So I support you in your research. And then he did a implant and he send it back to me and I did the research. And before publishing, I felt that that would be correct from my side to show him the results before publishing.

So I showed him the results. And then I would say that. Dr. Toma that’s that’s when I got I would say lucky, because he was like an angel in my in my life. I don’t know. We get along together quite well. We have similar lifestyles, let’s put it his way. And then he said, okay, I like your research. Could you present your research to my students and say, Yeah, yeah, I do this? And then I presented a research and then it was 2004 in a congress in Sao Paulo, and I’m from Rio, and this was a big show in Sao Paulo. We had Professor Brenner work on this show. They were celebrating 40 years. It was a 40 year anniversary of integration in Sao Paulo. It was a Saturday. And then, well, I had already presented the research and he came to me in the booth. We were in the boost for near the end, and he said, Sergio, you know what? I’m open and dental school in Chiba Lapel. And he said, You want to work for me? I said, Yes.

Yes, definitely. Why would you say no? There was that look. Was that like the opportunity of a lifetime?

Right, Exactly. Because he saw my presentation before and he said, You want to work for me? I mean, you’re doing a PhD, correct? So what if you work for me and I need people like you in my school said, Hey, that would be wonderful. It was a Saturday. And then I asked him when you want me to start, and he said, Monday morning, 8:00. And I said, Monday morning I’m in front of your factory. And then I get back to Rio. I was already married and I informed my wife as an A Honey, we are moving to Chiba.

Any kids that. This point or the family as well or. No, no, no, no. Okay, kids.

Okay. Hey, honey. You know Natalia. Well, I have a proposal, and I like this man. I mean, I like the way he’d been conducting the business. And, you know, Monday we are including Sheba. And I said, Come on. Are you crazy? Yeah. Yeah, let’s do it. And she was also another angel in my life. And we went together. And then Monday morning I was knocking on the on the door and actually being open and said, Come on, you serious? Are you really here? And then and to today he makes jokes on that because I think that’s yeah, it was really fast.

Amazing. Amazing. And so what’s what’s home life for you like at the moment outside of dentistry let’s say you’re not riding the horses or what do you do? What do you do at home? What do you do for fun?

Well, creative is a nice city. The quality of life is pretty good. Now I have a kid 13 years old, so I’m enjoying most of my time with the family. And also because of this international work that I do, you know, I travel a lot every year and then I’m coming to here to see my friends in a UK. And well, basically we like to travel.

Yeah.

And we have some friends in Katiba and it’s much more, you know, I dedicate my time to the family because I work so much that I think that in order to compensate my physical absence, I try to, you know, the the few moments I’m encouraged by, you know, I need quality.

Your present.

Yeah, that’s just what I do. I say, So what’s.

Your work life balance like?

Oh, my goodness.

It’s tough. Yeah. Yeah.

I work too much. Yeah. Sometimes they complain. Usually I leave home by 530 in the morning and I.

Go to the office.

About eight nine. But then in the weekends now I manage to stop and the weekends.

So on the weekends do they get 100%? Sergio. Yes. Yeah. Yes. And that’s important, right? Yeah. It’s that you can be there and not be there, right? You’re correct.

I think that most of the dentists, they love what they do and since we, we work with the hands and then it’s not an easy job. It’s a tough job, then it’s free stuff and we want to delivery it. Usually we centralise everything with us and then when you see you there, you know, in a big immersion on the patient and you don’t want to leave the clinic and to not finished.

So yeah, in Brazil, here in the UK there’s a lot of, shall we say, like little fear of patients sort of suing you for doing, making the wrong move, doing the wrong thing, blah, blah, blah. And so dentists are fearful on the whole of if I do this or try this or do that, or if I forget to do this, it’s my career on the line. Right. What’s it like in Brazil? Is it is a more relaxed what’s what’s the relationship there like?

Well, I can see that here and in the US it’s harder. But in Brazil is turning to that. We have in more and more legal problems with the patients and night. I believe that also the relation between the dentists and the patients is turning more, let’s say, physical and less emotional. Okay, So that’s when we have chances of this happen. So right now in Brazil, especially some wolves and Belo is the biggest city of Brazil. We have in some some lower lawyers that they are becoming specialists on health problems.

Screwing dentists over basically.

Yeah, dentists and many doctors. Yeah. So the attorney and specialise it on that. And like I said, you know, in the end of the day I believe that we are human beings. Obviously every, every, every problem, you know, everything in life has limits and bounds. But I don’t believe that most of my colleagues, our colleagues, they want to do something wrong to the patient. I believe that most of the dentists, they are trying to deliver the best. But but again, you know, failure can happen. And if you prove to your patients why you did this and that, and if you are convinced about your treatment planning, sometimes I think that people, even though you explain to them because the human relation is becoming different.

Less emotional.

Less emotional, is growing. And even in Brazil, and I tell you that Brazilian patients, they are really patients. Yeah, because already we run a lot of. International courses to get. And then when they see, you know, a dentist here from the UK coming to Brazil, when we are running courses and having these doctors come in today, I can see that they are really amazed with the with the Brazilian patients. But even though it’s.

Changing, it’s changing, it’s getting it’s get it’s moving in that direction, Right? Yeah. Just on that note of like making mistakes and stuff like that, that one of the things I ask on this podcast is revolves around this concept of black box thinking. So in the airline industry, they have this little black box in the plane and it records everything, right? When stuff kind of kind of goes off track or goes wrong or whatever it documents it. And that’s shared with the whole airline industry to improve overall safety. Right. Right. But in health care, we’re so used to brushing things under the carpet if we make mistakes. Right. But if we shared our mistakes with the world, everyone would benefit, right? Absolutely agree. Can you think back to any moment in your dental career where you had one of those moments where you thought, Fuck. What if I just don’t? And how did you deal with it?

You know, it already happened to me. It already happened to me. And I already had this moment. I remember here two big moments that I had in my mind. And I felt because I could see that I did something wrong. And then I felt really bad. The first the first feeling I had, it was depression. I was guilty. I said, Oh, no, I did something wrong. And for me. What I decided to do. I set out to have an open conversation with a patient. So I had all the data in my hands like models, x rays, and I decided to explain the patient what happened, what I’d done wrong, and what I could do to fix what I had done wrong. Hopefully it was possible to fix what what I did wrong, but I decided to have this clear conversation with the patients. And I believe that nowadays with digital dentistry and the moment we are starting to have more and more digitalisation of the patient’s data, it’s becoming easier to have this communication with the patient from the good things and also from the bad things. And also I believe that this digital dentistry can even protect us because we can show the patients the reason why we decided to that particular treatment treatment and then if it went wrong, we can prove to them that the moment we took the decision, there were reasons behind because we have everything, all the data, you know, it’s easy to achieve. You have it recorded, you have it in a cloud, whatever, in external HD. So nowadays I believe that the communication with the patient, even in difficult situations, can become easier because of digitalisation, of dentistry.

Going back to this problem, the patient, you explained everything to them. What happened?

Well, one of the patients from these two worst cases I had, one of them understood and well, we managed to to fix. So I contact another colleagues. That was quite important because in order to fix what I’ve done, for example, I need to do some orthodontics for the patient. So I contact some friends and they help me. One that I think that the network is quite important If you have friends to support you in a moment like that, it’s really important. And usually we then we work alone. And if you stay in the nutshell, not not a good way of doing it’s good to share and to speak with others and and keep your network on. So this guy helped me and the other one, I had to repeat the treatment and then again I explained it to the patient. I cover all, all the costs and I decided to the second surgery to invite someone with a higher experience than me. So I went to the surgery to redo what what, what I have done with a highly experienced doctor. And I believe that training and education is crucial because when you’re doing training education, you can share, you know, the challenges and the decision points with someone that is highly experienced than you. And that’s how I save myself from from this second situation.

What were the two mistakes?

One of them. I extracted the wrong molar.

Okay.

Instead of removing the first one, I remove the second mole in one of the teeth. The other one was a psychometric surgery. We did the zygote, my implant, but I didn’t have the proper engagement of the psychometric implant on the bone. And it was one of the first that I’ve done. And when I did it, I felt that I had poor mental stability. But then we did this in the hospital, and then one week later, when we did the tumour scanning that the the psychometric implant was actually out of the coma, what’s inside? And so sometimes it touched the bone and you have a feeling of mechanical stability, but actually it is not, wasn’t engaged to the osteotomy that I’ve done. And this was because I didn’t have the experience to open the flap correctly, a bigger flap in order to see what I was doing. And so we had to remove this implant and well, we didn’t we even didn’t do another osteotomy. The osteotomy was there is new.

Implant.

Exactly back in. But then the patient had to go to hospital for a second time and.

Well, thank you for sharing that Sergio, because I think it takes a lot to be able to sort of just admit your own mistakes. Right. And at the same time, for other people to sort of say that somebody in your position, a professor, somebody who’s involved in product development, engineering and all the rest of it, is also somebody who makes mistakes, right? So we can we can all do that and nobody’s infallible, Right? So, yeah, I think that’s you correct.

When when we ride horses, we used to say that you only fell from the horse if you hide the horse. Because if you don’t hide the horse, you never felt from the horse. So I believe for clinical practice is the same. If you don’t do patients, then you’re never going to fail. Because if you work with patients, you will fail. We are human beings and what we’re trying to do nowadays is maybe with, I don’t know, technology and artificial intelligence, with softwares, with techniques. We are trying to reduce the human error, but still we depends on human beings. And if you work with people and if you are doing clinical practice, be sure one day something will happen and you need to be prepared on that.

If you could advise a new graduate who’s interested in getting involved in implant dentistry. What would your advice be to that to that individual in terms of the career path, the courses? What do you say to them?

You know, if someone wants to do an ontology, the first thing I would advise is a study. You need to study a lot. Prepare yourself, prepare yourself, studying the basics. I think that you need to study anatomy. You need to study occlusion. You need to study physiology. And then when you are in dental school, you need to be prepared for that by studying the study, the basic dedicating yourself to the basic. I remember until today, the first surgery that I’ve done in my life, that I felt really secure because the first surgeries I was shaking and then and I was afraid of something can bleed more than normal. I don’t know if I can handle if I turn my if I turn myself to a difficult situation in here. But I don’t believe one surgery. Then I open the patient and I had the anatomy in my mind and it was, Oh, okay. So this is that. This is the way to put this. This is where here is where we have the muscles attachments. So when you start to apply the basics on your practice and you are thinking during the surgery. And this is really important because in the beginning you are only afraid. You are like, let’s say, acting on the defence. But when you study and you apply the basics on your patients, practice on your practice with the patient, then you feel confident and you know what you are doing. So immunology requires a lot of basic studies and then be prepared, be prepared to do courses because you need to finish to finish your dental school and to make it in patients. You need to do clinical practice. It’s not only about doing a one week course. Make any plans in the plastic job and you believe you’re ready? No, no, it doesn’t work like that. You need to do courses and you need to do courses in patients. So we need you to practice practical education.

It’s funny you. You mentioned that at the beginning, when you place in implants, you’re scared, right? You’ve got you’ve got this fear. Yeah. When? When, when I was speaking to him earlier, he mentioned a similar concept, right. That these patients. And you’re scared. Right. But he said when I was doing those first implants, I was playing the role of an actor because you can’t let the patient know that you’re scared, Right? Because then their confidence in you sort of changes. Did you have a similar situation there when you when you first started placing?

You know, when I started placing implants, I was worried about the next drill. Okay, which one is the next drill? So I was much more focussed on on the sequence of drill than actually in the patient.

Okay.

And, and I was sweating like crazy shaking. And again, I think that if I had studied more and then because for me you need to be worried about how can I open the flap, how can I release the flap, how can I suture properly? Like the sequence of truth is just as a consequence. So don’t be worried with the sequence of drill. Be worried about the implant positioning. Be worried about the patient’s health. And then maybe nowadays, you know, I would maybe have the catalogue of the company opening in front of.

Me in the order.

Exactly. You know, I would say, okay, let me look at that and then. All right, that’s the next rule. And I’m focusing on the patient and you should be focussed on the patient and not on the system.

Yeah, yeah, yeah, yeah. Absolutely. So coming towards the end of this interview, what we what we usually ask is I’ve got a few final questions and one of them is Sergio. It’s your last day on the planet. And you’re surrounded by your loved ones and you need to leave them with three pieces of life advice, three pieces of wisdom. What would you say?

That’s a good one. The the first one. I would say be yourself. Don’t pretend to be what you are not. You know, for me. My big personal journey is to understand myself. And I want to be myself. I don’t want to be someone that I’m not. So be yourself. Number two. I would say. Be humble. Because when you are humble, you you are open to learn. When you believe you know everything. You. You know, you’re living in a war that you’re just closing your eyes. And then when you close your eyes and you start only to think about you and you, you’re not humble enough to learn. You will fail. So I would say be yourself. Be humble. And I believe that you should be honest. You should be honest with people. I believe in energy. And if you if you give bad energy to the universe, the universe, we will give you back.

That same shit back to you.

Yeah, exactly. So be honest, be positive with people, and then the energy you get back is a good energy. Yeah.

And so what would you like this to say then? So Sergio was. Dot, dot, dot.

Oh, I would say. Sergio was a nice guy.

Simple as that.

Simple like that.

Simple as that. Yeah, mostly. Yeah. And imagine you had a fantasy dinner party. Okay. And you could invite any three guests. Dead or alive. Who would they be? I won’t tell you in the and situation.

The first the first person I think I would I would invite her to come would be my grandfather. I have had good memories of my grandfather. We had fun together and he was a nice experience. A nice example for me.

Yeah.

Yeah, yeah. So I would say my grandfather. You know. I don’t like to regret the good and needed the bad things I’ve done, the bad things I’ve done because no one is perfect. I try to fix. And so. I tried to be with the person when. When when someone is with me. And I believe that true friendship and true human relation, even though sometimes you cannot provide the proper attention to the person, the patient that the person deserves. If is a true friend of you, he wouldn’t, you know, he will understand.

You understand the situation.

Why you cannot be with with with them. So when you say three people is hard for me because I believe that a. Most of the people that I’ve been living with, I try to to be with them when we were together. So I would say, you know, I don’t feel that I don’t have this feeling, you know, I’m missing. I miss it to do this or miss it to do that. That’s why the only person that came to my mind was my my grandfather.

So that was one of my choices. Yeah. Grandfather. Just because I miss him today. Yeah. Yeah.

And maybe because he. I mean, we lost him when I was too young. And so let’s say I wasn’t mature enough to.

Proper.

Exactly to have a population with him. So that’s that’s why I was thinking about him.

Any celebrities or any one that you’ve sort of sort of thought, I’d like to sit down with that person one day. I wish I’d have had the opportunity to sit down with those.

And speak with someone. Let me say, you.

Know, over dinner.

Yeah. I don’t know. I think I would like to speak with Albert Einstein. Yeah, it seems like an interesting character. Yeah. Maybe. And you know who come to my mind when you said Clint Eastwood? Maybe because of the cowboy movies.

Yeah, yeah, yeah, yeah. That’s cool. That’s cool. Sergio, thank you so much for your time. Appreciate that. Thank you. Thank you so much.

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.

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

In part two of Payman’s chat with Sam Jethwa, Sam discusses how working alongside a clinical psychotherapist has transformed his black-box thinking.

He reveals why he chose to practice in Marlowe over London and lets us in on plans for his upcoming BACD presidency.

Enjoy! 

 

In This Episode

02.49 – Marketing and profile building

07.55 – Blackbox thinking and clinical psychotherapy

26.20 – Marlowe

30.50 – BACD presidency

34.07 – Last days and legacy

39.14 – Fantasy dinner party

43.51 – Fantasy podcast guest

 

About Sam Jethwa

Following completion of a postgraduate diploma in clinical education with the Royal College of Surgeons and Physicians of Glasgow, Dr Sam Jethwa has carved a career as an engaging speaker and educator on smile design, occlusion and functional success.

He is a board member and vice president of the BACD.

To suggest to a patient that I think you should speak to a psychotherapist as the dentist. That could go only two ways. One could be positive. They could be open to it, or one could be like, What are you saying? I’m crazy? You know, It’s like and I guess I had to use various communication techniques to introduce that. And when I introduced that, she said, I’ll try it. And I always I said, I’ll pay for the first consultation if nothing comes out of it. I’m happy to remove everything and restart or let’s see what to do right. And she goes, okay, she did. He called me the next day and said, She’s giving me consent to speak to you. There’s nothing dysmorphic. Everything is fine. There’s no trauma in the past. There’s nothing going on. But I suggest you don’t do anything for three weeks. And she’s agreed to that, too. So she woke up in the middle of the night after having had the therapy about two weeks beforehand and realised that actually she just was seeing getting the emotions of her dad, losing her dad every time she looked in the mirror. And because the only thing she changed about herself was the teeth. It had to be the teeth.

Crazy man.

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 selling cake.

I think, look, the real worry is there was a time where the man in the street, like the cab driver in the street, would say, I’m going to get my teeth done and I’m going to put crowns on all my teeth. And he’d be the 60 year old guy who mistakenly thought that was the right move. But at least he’d be a 60 year old guy. Exactly. Now we’re getting 21 year olds.

Yeah.

You know, and I think Shorty said something on Tick Tock about you’re going to end up with dentures. You know, I mean, she just said like that. Yeah. She said she essentially said, look, you’re saying whatever you’re saying and you’re feeling whatever you’re feeling. But also consider that you’re likely to end up with dentures now because of this. And we are, as a profession, guilty of not getting that story out enough.

There’s a restorative cycle, Right. And patients need to know that. And then the sooner you start that restorative cycle and the more irreversible, irreversibly you start that cycle, the fewer options you have. So it’s not even that you have to replace it. Some report saying, oh, you have to replace them every ten, 15 years. You’d be lucky to get ten years out of this dentistry. You’re lucky to get five years. We have people coming in, sitting there with little to no tooth left and nothing we can do about it. And then 2123.

So tell me. But when I asked you about the sort of the talking about it. So I wasn’t, I wasn’t really asking why I get why, but how I mean, what you do marketing wise. Yes. You treat people really well. Yeah, I get it. But you have tactics. Do you do you like. I see. For instance, I’m on your site right now. You’ve got these amazing basically the blog posts of questions that people probably asking on Google. Right. What are possible? Some veneers. I bet that works well. I bet these come up well when people.

Wish I knew which one works, which ones work well, and which ones don’t.

You can find out, right? I have no idea.

Because.

Oh, that’s the technophobe. When you call yet.

Again, this is something that I don’t know many people know, but Bespoke smile is owned by me and my non clinical director.

Okay, so he takes care of that.

She she takes care of all of that, which means my focus is clinical dentistry, BCD and Bespoke Design academy the dentist I’m a spokesman academy are my big huge passion and really the dentistry that I do now I do so I’m still in practice, I’m still learning and I’m still every day picking up different things in every case, thinking we could have done this, done this, done this, and breaking it apart so that I can bring a better level of education.

And I take it your business partner isn’t in this photo. The clinical team.

Very well respected in her field of management consultancy and has turned a lot of businesses around in the past and dentistry was new for her. Actually, I’ve known her since we were kids since we’re about 14 years old.

I mean.

And it’s scary to go into business with someone that you have known that long. It is. Sometimes these things don’t work, but we took the risk and so far so good because we have very, very different passions and different skills. What you’re looking at those blogs and the marketing is all her. I just get told what to do. I get emails that write this article for this so-and-so magazine or write this blog, or we’ve got this blog writer who is like 17 and in school holidays and writing blogs and things like that. Can you double check it? I get sent all sorts of things and I just get corrections and things like that. It’s a daily thing. The strategy, the decisions, the what we do, what we don’t do is really not me. What you will what you should know is that everything on my Instagram is 100% me. So any of the video content, what I put on my page, that is, there’s no strategy there. It’s what comes into my mind, what experience I may have had on film and that will go out there and that’s it. So I don’t have any managers who run that for me or anything.

And so, so do you do you do have a master plan that you’re going to should we go all Robbie Hughes You’re going to stick one in every world capital.

Um.

Oh.

Yeah, that. By the age of 30, I’d have ten practices. I’d be playing golf, I wouldn’t be working. And then I see people like you play who’ve done very similar things to that, except not with practices. You know, you’re not having to go into them, not having to see patients, having to go, you know, you’re working on exciting parts of dentistry that need people like you to be to be in the lead of. And I always thought that’s where I would be. But I still loving my clinical dentistry and I’m loving my academy dentist and I’m growing that side a lot. That is really my focus the last year or two. I’ve been growing the academy. I’ve been offering more of what I’ve been asked, asked being asked for, and how we can deliver education. We’re now international. We’re seeing dentists put up on my Instagram all the way from Botswana to come to the training.

I know.

That that was a huge privilege for us to host her and dentists from Ireland, Scotland.

And we have long courses and short courses.

We had we had two courses and I scrapped those courses because it was a little bit of information that was that was actually a bit scary to leave people with. You can’t just show someone in two days how to do veneers and then and then not give them the occlusion and the treatment planning and the psychological assistance with the patients and the emotional side. And you can’t do that. So I got rid of it. And so my focus really is not on practice growth or more practices. Yes, that is in our mind. And that is that is possible, but it’s not where my headspace is right now. My headspace right now is how do I deliver the best education for the First Man Academy and answer more of the questions that our delegates are asking for? And in what? In what way? Is it online? Is it is it in-person? Is it hybrid? What is it? And that’s where my focus is right now, is I really want to grow that that side of things.

So I want to talk about your back stuff a bit more, but. I’m very keen on the dark side. We hear about errors.

Errors. The device.

No, no, no, no. We’ll come to back later. Okay. Errors, clinical mistakes. Times where you’ve you know, you talked about the psychological side of it. Just something tells me you learned that the hard way. Yeah. Even even with my limited experience, I fitted veneers or whatever, and the patient was over. The moon, went home. Best friend said something, came back in tears. That whole thing. Tell me about things that have gone wrong.

Things go wrong. Things have gone wrong. Luckily, I would say now. Through all those mistakes. Things are very, very slick. So if something happens, it’s almost a shock to me that this has happened and then we’ll see why. But we have the answers to why, because we now know we’ve made nearly every mistake. But big mistakes are managing patients expectations. That’s why I talk about the emotional side and the management of the side management side of the treatments. Specific reason do attract patients who have high expectations. Definitely. And that is especially at the level that I’m at. Right. Or let’s say a central London high street veneer practice might be that things are going to be attracting patients who have either existing veneers. And I see patients who have had veneers by the top people that you and I both know, and they’re coming to me and they’re asking for things to be changed. And it’s like, you know, there is a there is a psychological element to this. I don’t look at my teeth as closely as these patients do. And so we’re dealing with people who have very critical eye. But a lot of the time it’s about accepting things, but educating the patient in order for them to accept it. So I call it trade offs. This is the number one mistake I used to make. I never talked about this.

I was taught really to sell a dream and I wasn’t really skilled in any way to manage what happens if that dream doesn’t come true? Beautiful. And that was the biggest problem that I had to fight through. And now I call it trade offs. And I have this conversation with my patients. Some of them do think that I’m a little bit I mean, you talk about communication and you mentioned I’m a good communicator. Some of my patients don’t necessarily like. How direct I am sometimes about some of these things. But what I think they do trust is they trust where it’s coming from in terms of they know I’ve done this enough times that I can say confidently, you will not like that because of this factor. So, for example, a simple one is colour and my Instagram, I’ve talked about this again and again and again. People will come in wanting white straight teeth, but I want them to look natural. That’s the add on bit that we now have, right? And then it’s sort of they know that my vibe is not super white teeth. So we get to my whole process is about creating a set of temporaries that are absolutely diagnostic, whether it’s functional, whether it’s looks. I make so much effort on the temporaries, sometimes the temporaries to the finals let live up to it. We have a process with the lab technician where they should live up to it like they absolutely should.

I approve every single veneer that I fit. I will not let one come out of the lab unless I’m happy with what pictures I see in the lab. So that process is really strict. But in terms of the patient, they don’t necessarily know all that if I’m going to. All they care about is are they going to get what they wanted. And sometimes patients will want everything, but they don’t know that they can’t have it all or they don’t want to hear it. So how do I explain to a patient that usually doesn’t want to hear it in a way that will help them to understand and accept it to make them happy? It’s not about making an excuse for something because I can do pretty much what they want, but I know that there’s some aspect of it that they won’t like, for example, colour if they want it really white, but they want the teeth to look natural and they want the teeth to look small and they want the teeth to match with the lower. And then you have the added issue of what’s behind it. So obviously they’ll be enlightened beforehand to death and they have no more yellow ness and all that stuff. But that understanding of the patient, I’ve now done it.

I’ve made teeth that are too white and they’re thicker because the technician had to have to layer more porcelain. How do I do that stuff and then say to the patient, Yeah, you can get some more teeth? So I now have a trade off conversation and if a patient says to me, I want X, I want longer teeth, it’s that. Okay, let’s break that down. You want longer? See? What does that mean? What is it you want to lengthen? And then they’ll and usually it might be that the laterals are too. Too long. Too long. Right. And essentially, they may not be. They need longer teeth. So you need to deconstruct everything the patient sets and then say, okay, you want longer teeth, what can you handle? Because there’s no point making you something that’s going to break. So let’s add some length. Let’s test it out and then let’s see. And they say, right, if you have these longer, the side effect is going to be that that one is going to look shorter or your canine guidance might go, well, what is the next step? It’s not just about saying, oh, yeah, we’ll give you that. What is the side effect of that? That is where I made huge mistakes because I was led by the patient way too much. And I didn’t I was too scared to.

Explain the trade-offs.

Or explain it. And there’s another video that I put out. You can see I went through a lot a few years ago when I made a video because one of the videos is called saying No. Right? And I start that video by saying I’m saying no in order to help you to say yes. And the reason is that I know they’re going to love it, but I have to get them out of the frame of mind of what one, one, one, one, one, one. There’s an understanding. And those communication things, that understanding things I learned the hard way because I had to redo a lot of cases. I had to figure it out because by spending time at the lab, Why is it that when I ask for this, this is what’s coming back? I just did pop ups at the lab. I used to just turn up randomly to see who’s got my case, which lab technician is working on it, What is their technique? Why is there no consistency? And then I learn a lot about how the materials are used, and that’s when the trade offs thing started.

So, look, the I think when we’re younger, sometimes the thing you said about selling a dream, it’s almost a conversion. That’s the most important thing, right? Because you haven’t done any. You’re thinking that’s what the goal is. Then as you get older and I guess to be blessed, be let’s call it what it is, you’re, you’re more secure in yourself, you’re more secure financially, you’re more secure reputationally. You know what you can and you can’t do. Yeah, I was having this conversation with Andrew Dorward and he was saying, Yeah, look, people mistake talking about complications as something that’s going to lose you the case. But actually, if you talk about complications with authority, the people think, well, this guy knows what he’s talking about. They actually trust you more. So so I get the conversation piece, but I still want to explore the moment something went wrong. Like a God moment or a patient who went berserk psychologically.

I’ll give you an example. Where no matter how much communication, no matter how many trade-off conversations, no matter how much evidence, I have to show that we did everything correctly the first time. The second time. The third time. And the fourth time. The problem that the patient was going through is not going to be answered by dentistry. That’s what the conclusion in my mind is when things now with our workflow and everything that I know now and mistakes, if something gets to that stage, I know that it’s not the dentistry. So I have to now learn to. Well, we have to all as cosmetic dentists learn to pick that up early. And so this case was a case where we had a couple of veneers. She had existing on the front teeth, very old veneers, slightly canted. We agreed to less units than I would have agreed to do now, because I know that wasn’t the right number, because it’s never going to look right on the right hand side. And so we did that, and they looked pretty good. They were a copy of the Temporaries. So fine. Then the patient was going into BCD meeting a few years ago, and I was late because I was on the phone to the patient because the patient was really panicking that she doesn’t like them, doesn’t like it, doesn’t like or do not like about them.

You just got to get used to it. It’s very new, but there shouldn’t really be that when you go to the final set because the final fish should be a copy of the temporary. So the shock factor should really be had been earlier. So that was a bit of a concern. But I thought, okay, some people do just take time. There are groups of people that take a lot longer to get used to things. So then we left it for a bit. Then she sent me another. I can’t get used to it and need to discuss it. Come in. Fine. We decided to change them with some changes. Some corrections didn’t like them. Same thing happen again. And then it was a case of you were happy with the temporaries? Yes. Let’s make an exact copy again of the temporaries, which we did and then still doesn’t like it. And like for different for the trade off reasons. Right. So, for example, I want I want that bit cut. I want she had a bit of a counter smile so we.

Had to cut it. I get it. I got it.

One side had to be longer in order to straighten out the arch, Right. So to do that we had to make one side longer. But I think it’s too long. If you bring it up, we can do it again. And it’s like a back and forth back. But what is the trade off? You either have a candid smile or you have one side longer than another. The fact is it doesn’t actually look longer. It looks correct. So that’s the thing. And I’ve been through this scenario more than once, but it’s just a rehash unless we get into the tiny nitty gritty of like the expectations.

No, no, I get it. I get it. Do you now have a spidey sense for it or is there a process like do they fill out a questionnaire that.

We started the questionnaire. I don’t know what happened. It just kind of didn’t didn’t stick. What I do have a sense now, I do and I can sometimes get it wrong, you know, sometimes it’s still a skill. It doesn’t quite work. There’s still someone who doesn’t have the right expectation at the end, and I can’t really work around it most of the time. No, but I now work with a clinical psychotherapist.

To you.

Who is actually a patient of mine, and he has been through the treatment. So there’s no one better to help people than him is also, he’s professionally trained to deal with people with dysmorphic tendencies or difficulties. Difficulties adapt to change. I have an incredible story about a patient of mine that we treated, and she had a lot of things we could correct. My wife did some gummy smile. Botox. We raise one side of the mouth with soft tissue laser. I placed some super minimal prep, no prep on the size veneers case was stunning. The really beautiful. Couldn’t get used to it. Couldn’t get it can get used to it. But very, very lovely, very understanding patient. The best things go wrong and the patient is on your side with you, you know, that’s the that’s the we’re so lucky when that happens because we’ve got to work together with the patients and that’s what we always try and we don’t want to be fighting with them about it. So this was one of those cases and we had a WhatsApp group, me and my wife and the patient. We’re trying to figure out what can we do with this? And I said to her, and this was this was really to suggest to a patient that I think you should speak to a psychotherapist as the dentist, that is, you know, but that could go only two ways.

One could be positive. They could be open to it and one could be like, what are you saying? I’m crazy? You know, it’s like and I guess I had to use various communication techniques to introduce that. And when I introduced that, she was she said, I’ll try it. And I always I said, I’ll pay for the first consultation. Nothing comes out of it. I’m happy to remove everything and restart or let’s see what to do right. And she goes, okay, she did. He called me the next day and said, She’s giving me a consent to speak to you. There’s nothing dysmorphic. Everything is fine. There’s no trauma in the past. There’s nothing going on. But I suggest you don’t do anything for three weeks. And she’s agreed. That, too. And then he then he called me and said how she spoken to you? Because she said she’s going to she has discovered that she had the veneers done because and this was in the back of her mind, she was nursing her sick father for a year before he died. And he died soon, soon before she came in to see me for a consult.

And she has grown up in a society that’s abroad and another kind of Switzerland where they’re very polite. There’s a big divide with respect of a professional. And so there’s that slight issue. And then it’s the case of she never really had a concerns about her smile. She didn’t reach she wasn’t really that bothered. Someone had said to her once, Oh, you’d be really pretty if you had a nice smile. Sad, but we hear that a lot. And she did her teeth because she thought that that would solve the grief and things like that. And it wasn’t that she didn’t because she was very vague about what she didn’t like, which is when when I start thinking, is it something else? So if anyone wants a tip, I would say someone is not specific about it or they can changing what it is, then sometimes it’s not the teeth. It could be something else going on. So she woke up in the middle of the night after having had therapy about two weeks beforehand and realised that actually she just was seeing getting the emotions of her dad, losing her dad every time she looked in the mirror. And because the only thing she changed about herself was the teeth. It had to be the teeth.

Crazy man.

And she ended up continuing the therapy with with the therapist for a while, quite a few months about other aspects. And a lot came out that was not the teeth were just the just one of the things.

The name she’s given to her pain the.

Facts of the issue. So she she feels still patient about and she’s fantastic. And we removed the veneers and only the front teeth with Canted Midline had the contact opened, so we did some composite veneers for her on those. All the rest are her original teeth because there were no prep veneers. And this is why I mean, this is not that you’re going to have to take them off for every patient, but we took them off. Our teeth are exactly the same. Just super happy. All that emotion she felt. She said to me, I feel like in the chair a weight has been lifted. It’s like release. Soon as the veneers just had to go.

It’s a beautiful story, man.

And that was because a patient was open to me, suggesting, talking to someone else about it and had another patient last week who said, I’ve actually start not she’s just got it’s veneer related but it’s not really it’s it’s and she said I’ve started therapy because this is not about my teeth this is something else. And I think now it’s not as much of a taboo thing. And I have suggested it to many patients sometimes before they start. And it’s some people just say, No, that’s not for me. Okay, fine, maybe come back to me in a few months or some say, Yeah, okay, that’s interesting. Then we do that. And I think that we should, as dentists, be really working collaboratively with people like that, especially at this level of cosmetic dentistry.

So it’s such an interesting learning thing that you just said. Although I think my idea of dark and your idea of dark is slightly different because that seems like a success story to me. I’m looking for a failure story. I’m like, Oh, shit, man.

Um. Clinically, I guess clinically it’s. I don’t think there is one. I’ve not taken out the.

Wrong ID You never did. You never fit, fit the teeth and just somehow you are unhappy. You’re.

Yeah, but that’s not so. This is a good this is.

I don’t know. I’m making it up as I go along. I, I am.

I believe that a case is only successful if I’m happy with it. If my patients happy with it. That’s a base level of success for the case. Yeah, that’s not enough for the case to be successful. It should be both. And if I if I listed every time I was unhappy with the case, we’d be here that you’d never finish.

So, Matty, you know Matty Parsons, he lectures on our composite course, and.

He actually did our training a couple of years ago. 2020?

Yeah. Yeah, he said, he said he he talks about with composite veneers, the most difficult patients being the ones who say, Listen, I trust you. Leave it up to you. You decide because. Because you don’t know what they’re thinking at all. And in a way, you’d think that’s a really good idea. Right? Because give Sam carte blanche to do what he wants to do. But actually, he says they’re the hardest patients when they say white and straight and blocky. At least he knows what thereafter.

Of my workflow is allows them to experience it before they have made. Yeah, yeah. Made the commitment on the shapes and the size and the colour and.

Compared to composite.

Which is the difference. So that slightly is on our side. So if we do get it wrong, which we very rarely do now, right, but we might get it wrong in terms of some of my one squarer look or some of my white teeth, and they’re not honest about it initially because they don’t want to put me off. Sometimes it’s not about us getting the case conversion. They want to get us to convert to good.

Yeah, yeah.

And so and so sometimes you get that wrong, but there isn’t that permanence in our process, so it gives us that flexibility to adapt.

Well, why did you choose Marlowe? I mean, I know it’s a beautiful part of the world. Yeah. There’s there’s, you know, I’m sure there’s well-to-do people there. But nonetheless, you could have gone to central London. You could have.

Yeah. I was never drawn to central London for my first practice because I was nervous about it. I was really, really scared about doing it because I had been told by someone I really respect in the profession that I have what looks like. I have the skills to make a really good associate, and they could see that I probably am a good associate, but not the skills to be a principal and run my own practice or build a brand or. Or be a leader. Because it’s a different set of skills and it’s not for everyone, which is true. It is not for everyone. Right. But I always thought I did have those. So to be told that I don’t have those was really upsetting because I was kind of craving their support for the next step. So what happened was it drove me. I was that I have to have to like if anyone tells me I can’t do something, that’s it. Basically that’s the end. I will. And I have I have to because I have to prove them wrong. But I almost have to prove it to myself that I can, because now they’re putting doubts in my mind that maybe I can’t do it.

So I was in that frame of mind, and so I actually looked for practices that were not in London because I knew would demand something different of me. And maybe I don’t have that. And so I looked for small practices where I could keep my associate position because if everything went wrong, I’d be okay. I’d be able to pick up more days again or something. And that is really that’s how not confident I was to do that. And it’s one of the reasons I even brought on a non clinical partner because I was like, I have an associate job, I can’t run stuff, I can’t decide marketing, I can’t do that stuff as well. So that was how Marla was born, because it was a two surgery practice in an area that I had only been with my with my family for picnics and stuff. It’s a really, really beautiful part of the world, but I didn’t know it well. I knew it was affluent and I knew there’s a lot of Michelin starred restaurants in the same high street.

It’s a beautiful And.

I thought, Well, it must have something about it if, like all these celebrity chefs want to be.

There. Sure.

So that’s that’s why we chose that. And it was affordable to me that it wasn’t a huge financial risk for me and my wife. So it was really about mitigating risk. And that’s how we ended up in Marlow. There was no thought other than that. And then I heard that there were eight other practices in and around the high street, and I started learning all these things and people like, Are you sure? And you know what? The people the clients are like this and that. And at this point it was too late. So it’s just like, well, we just have to we have to make a success of it. That’s not an option.

And say you would have done differently. As far as the practice.

I would have got a bigger site because we have that problem.

You’ve grown into, you’ve grown out of it.

But you know, what would I’ve done differently? There’s not a lot actually. I’m very comfortable with what we’ve achieved, but I am craving a little bit more in terms of space and in terms of being able to house a little bit more for the facial aesthetic side. To my mind, if you.

Don’t do the teaching at the practice, would you do it somewhere?

Yes, we’re lacking a bit of space for that. So we do it at local. Local. We have like a mini conference for the first weekend of the six day course. So it’s all in one site, a really nice hotel nearby, but it would be great to have our own facility for something like that so that there’s that kind of thing that I’m missing that. But it doesn’t impact anyone’s experience of the course. But from my personal, it would be it would be nice. And yeah, I guess it would be nice to be in London, but I’m again, not craving that. I live in London. It would be much easier for me. But you could.

You could move to Marlow.

Know.

It’s an amazing place to live. Now.

This is slightly too far out for me. I need to be on.

It to be half an hour from the restaurants of Mayfair.

By the tube like tube. And my wife works in central London. And she said as she walks to work, both sides park in Hampstead and she she needs to be accessing town. So no, not too far. And I love my patients, but I’m sure they don’t want to be sitting at the Ivy next to me on a Friday.

Or you do. Let’s finish it with back again, back to where we started. What can we expect from a sound presidency? By the way, When when will you be the best? Is it.

Before me? You know, we don’t get ahead of ourselves. We have to celebrate Simon’s year. He’s going to be amazing. Then we’ve got Luke Hutchings. Who?

Oh, it’s Luke. And then new.

President elect this year. And then I’m VP this year. So there’s a two year. Yeah, yeah, yeah, yeah. What’s going to happen? I have absolutely no idea that I’ve got. We’ve got two presents. We’ve got, we have two boards and we have new people every year joining the board. And so the direction the book is really set out for that year as our strategic planning weekend, which is this weekend for Simon’s. Yeah. So we just don’t know. We are thinking of ways ahead in terms of conference. As you all know, we start talking to you guys for our conference site years in advance. Right. And we have to plan ahead. But other than other than that, the direction we really listen to the members and we really try and give the members what they feel they lacked the previous year. So feedback is so important and we want any members who are listening to this. I really would want them to come and even just even just DM me or whatever, just.

Say, can I say my pick and I say my bit. Yeah. So, so yeah, I’m thinking this like sort of like a warehouse. Yeah.

I love that. So, hey, this is interesting. Wow. We have to select somewhere for 2025, which will be then I think it’s the 2025.

Hopefully by that, by that point I’ll be sitting with your friend in. The Cayman Islands.

But for two years time, I don’t care if the conference is going to be open.

They call it in event terms, they call it blank canvas.

Yeah, a blank canvas. Yes. I would love something. I would love something. I think that is something really cool and I would love to do something like that. I’m not the only person that makes decisions.

And so now that you youngsters are coming through now, maybe there’s a blank canvas. We’re talking gigantic single screen, not not three small screens and then bar bean bags, neon food while you’re watching the lecture.

I think there is there is definitely a lot that can be done. And we’ve got to we I don’t know if you’ve noticed the production level stepping up a little bit every year.

I did.

Yeah. So there’s little things that have been happening, which for me I love, like the lighting and that opening ceremony and the smoke and the music and the really top production filming that we have and all that stuff I think really is necessary and I want to keep building on that. And every year I just push for a little bit more so. So who knows by then? Who knows by then we may have sort of a warehouse project situation, I’m not sure, but I definitely not the only decision maker. And of course, we all know Susie Roland’s the queen of CD. And if she’s happy to run a conference in the warehouse, then then maybe it can happen.

I think I’ll have a little chat with you. Yeah.

Definitely. Listen to you.

Let’s finish this. It’s been a pleasure talking to you, man. A long time coming. So let’s finish with the usual questions that we finish with. Are you ready for fancy dinner party?

Oh, God, no. Fancy dinner party?

Three guests.

I didn’t want to be, like, obvious, you know.

Dead or alive.

That’s on Olivia. You know, I’m so bad with celebs, you know, I don’t know any celebrities.

Doesn’t have to be a celebrity. It could be. It could be Einstein. Your grandfather.

Yeah.

Jesus.

Yeah. I don’t really want to have dinner with my granddad. I never knew him, but I kind of don’t. I didn’t really want just.

I just threw that out.

I was like, Yeah, I do.

And then we had Jesus the last. Last time. Last kiss.

Really?

Yeah. So don’t say Jesus either.

I’m not going to say Jesus as long as they’re Barack Obama.

Barack. Yeah. Well done. Well done. Nice.

You’ve got to respect. Why have they gone out of my mind in terms of like people that have done amazing things? Oh, I got one that is actually really out there, which I definitely want to go, but only three.

Good.

Oh, can I say one? Have you sent the question?

Oh, no, no. You’re not coming in with a third guest?

No, I’ve got one so far.

And you got Barack. You got Barack and Eleanor. Oh, oh, oh. Are you saying. No, I was just saying that the cliches.

Then they are. I’m sure many times before.

We’ll come back to them later. All right. Deathbed.

Deathbed.

You’re on your deathbed. You’ve got your nearest and dearest around you. Three pieces of advice. You’d leave them and the world.

Three pieces of advice. Number one, life is all about relationships. Because relationships can make or break your emotions, but also where you go next. So be nice to people on the way up because you might need them on the way down. That is definite, number one. And I really believe that a lot. Number two would be don’t rely on anyone else. Be your own person and and keep going in the face of adversity. Never let anyone else tell you that you can’t do something. Learn for yourself whether you can or not. Then let someone else make that decision for you.

That is nicely put.

Now, that could have happened to me and I didn’t let it happen. And I’m glad I didn’t. And what else? Find a suitable partner. If you want one, because. I could not be sitting here at 10 p.m. and I’m sure you would not be able to be sitting here in 10 p.m. if it wasn’t for the significant others in our lives who accept us for what we want to do, sometimes put themselves second for what we want to do. And that is. Is the number one thing. For me, I’m extremely lucky that I found Natalie, who supports me in everything and Will. I’m present. A lot of the time, but I’m not present. I’m pretty much never not in front of a screen or doing something. Either writing courses or something to do with the practice or something. Or I don’t go to social events. She has to sometimes go on her own. And those are things that are a huge sacrifice that not every partner can handle and that could make or break, I think, a career. So that would be the third thing.

Very well said. Very well said. But when when when you chose to ask the big question, I asked her to marry you.

Yeah.

I’m quite interested in this year because what happened to me was I’d been going out with my my girlfriend for ten years or something. And then at one point I said, Right, I’m going to ask her. So what was it that made me do that? I had a moment of clarity regarding a wheelchair, regarding like I was I was going through something. And I thought, who do I want to push this wheelchair? And I thought, Oh, it’s her. Like, I wasn’t going to call my brother, my parents. But but, but, but with our government asking to marry me. And it is an interesting situation, right? Because, you know, life, when life’s good, it’s easy to enjoy it, right?

Yeah.

And we and we all have wheelchairs, whether they’re real wheelchairs or not.

Absolutely.

Are you going to tell me or.

The three guests? Yeah. Could you see that? I was noting something down.

Yeah. Yeah, exactly.

But, you know, when when me and Nat decided to get married, we had a lot of adversity to fight. It was a year of absolute hell. And that, I think, has made us a lot stronger.

Because you saw what you saw. You saw what each other is like when the chips are down.

Worst of the worst. Yeah. Yeah. And I think that’s helped us. Who knows? We’re going to be married four and a half years, right? But there’s a lot that I’ve done in my career in four and a half years, and I would not have been able to if it wasn’t for her letting me do that. Three, three people. First would be Jeremy Clarkson, because, you know, it would be an absolute laugh.

Yeah.

Yeah. Right. And he’ll say something outrageous and it will be funny.

And which is I hate to admit it, you’re right. It would be a good party with him.

It would be it would be worth listening to. And I’m sure he has got some incredible stories about guests.

And stuff.

And trips, and I think that would be great. The second I think is probably a bit cliched, but I would I would actually love to learn a little bit more about Richard Branson. I think that I remember as a as a child, the air balloon ride thing and nipping that first kind of slightly outrageous entrepreneur in my lifetime. I think that’s quite interesting putting yourself out there so much and having that confidence.

But, you know, interestingly, interestingly, we think that sometimes with entrepreneurs. But but, you know, the guy who owns, I don’t know, like. I know he’s written a book and all that, but he’s not out there as easy. No, it doesn’t have to be that way. But you like. You know, I almost started Enlightened because of Richard Branson, not just because I remember buying this ticket for Virgin Atlantic. And I was going to fly a Virgin Atlantic and I wasn’t going to fly any other plane. And suddenly sitting on this plane and thinking, what the hell did that guy just do to me? You know, why was it I was insisting on it and not that I was having a bad time, I was having a great time with it was it was it was delivering. Yeah. But I felt that he had done it to me. Yeah. It really sort of woke me up to this idea.

I’m fascinated by entrepreneurs who have fingers in many different industries because in dentistry I definitely feel that we and I definitely I feel that I don’t I don’t know where to even begin. If I was in a different industry. I have a huge passion for property and development and I love that sort of thing. And we do a bit of that here and there. Definitely not in terms of a business, but that is a huge passion of mine. I don’t really know where to start to turn that into a business or even other things I would love to do, but I just don’t really know and I would love to learn from someone who is who’s been in so many different industries when how do you get the right people and how do you how do you branch out just from whether it’s something we do or we don’t do? But it’s just really I would love to know that because I feel like that was a. When we have a vocational qualification.

If you read his books.

Yes.

Yeah. Excellent.

And then the last person, which is a little bit random is Kris Jenner.

Kris Jenner of Of the mother. The mother? Yeah. Yeah. She’s a genius.

Exactly.

She is a genius.

I really do think that she is a genius. Whether anyone respects them for what they’ve achieved or not, it really doesn’t know.

She’s a genius.

You’re right. I would just love to know.

She reminds me of that guy, the wife of Ozzy Osborne.

Sharon Osbourne.

Yeah. You know, like that genius media person, because, you know, you got Ozzy, right? Yeah, she turned that into me.

And I used to watch The Osbournes as.

Me, too.

We do TV, and it’s incredible. And I don’t watch the Kardashian stuff and my wife watches bit in there and whatever. Like, I’m not into that.

I get it. I get it, I get it.

I just think to create a business out of that, I’d find that really interesting to to hear from.

It’s the same way, I guess it’s the same thing. I really, really admire Red Bull, the company, but I don’t drink Red Bull.

Yeah, yeah, yeah.

It’s the same sort of story. Amazing. So one final. Final. Who would be your dream guest on this podcast?

I think we’ve got to get I would love to hear Larry Rosenthal on here.

He’s been on. He’s been on.

And he said, watch that.

It’s unfortunately, the sound quality wasn’t amazing, but he’s been on.

Okay. So scrap that, then. Yeah. It’s got to be someone you can get on. Is that.

No. But the show is called Dental Leaders.

What’s the name of that lady? Yeah. Not really. Who do I love to listen to in dentistry? Um.

I’d love to have Caleb, by the way.

Have you done it? Has someone asked you the questions?

Yeah, that’s happened. That’s happened.

I would love that. Because you are one of the people that, again, industry I admire hugely. That’s what you’ve done. You’ve always been so supportive of young talent, and you always used to give me words of wisdom and things like that at conferences. But it’s the.

You execute it. I remember I remember telling you, Hey, become a veneer guy. I don’t want to take I don’t want to take the year.

I remember having that conversation with you. It was hands on day on Thursdays outside Amanda’s session. And that’s what you said to me.

It’s Sandra who’s a veneer kind of person, right? She had a great tip on veneers. She said that she can still hear me. She said she. She said to you that she tells all her patients that if if it fits and it’s right on the first go, then it’s very, very rare. It could be the second or the third. So it’s all all veneer patients says to them what she would say to a single, single veneer person so that when it works, it’s great. It’s amazing. No one, no one has a problem. And people are like more appreciative.

Yeah.

On the first.

Interesting, I have the entire opposite conversation.

I said perfect first pitch.

Perfect first time in terms of fit and the copy of the Temps. And if it’s not, then there’s something I have not done right.

Oh, that’s nice.

Too, because the process should not we should not be having surprises on the Fit Day, and I’m not familiar in other people’s workflows, but.

I don’t think she has that many surprises. But she was saying that to have that. So the patient then is doubly, doubly happy when it’s.

Yeah, I can see I definitely the single Centrals is like, yeah, it could be eight times. So not eight. But, you know, that’s I mean we all have our workflows, we all have our way of playing things. In my mind, I always say it should and it very rarely isn’t. And if it isn’t, then I’ll make it right. Because it should.

Be.

It should be. Who would I. Who would I want on here, though?

Yeah. Who do you own?

I would love Gallagher. I would love to hear him because I would. I would love to hear how he feels. Veneers have changed because I definitely have seen that, right? I’ve been in practices where it was the old way and the new way, and now it’s different. And I’d love to know that. I’d love to know how the practice still works and is successful after so many years. And I would also love to hear his take on the dental tourism and how he feels. Yeah, one of the world’s best dentists in a country where this is going.

On and a great speaker. A great speaker in a second language, right?

Yeah. And so I’d love to I’d love to hear I’d love to hear him speak.

But it’s been lovely talking to you. Really has. I’ve really, really enjoyed that. Thanks a lot for doing this.

Thank you. Really, really nice to connect with you.

Okay. I’m going to see you again in real life.

Yes.

You’re going to parties anymore. Any more events you’re going to this year?

I don’t know what’s on. No idea. If it’s in the calendar. I’m there. It’s not.

Thank you so much, bud.

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.

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

If you did get some value out of it, think about subscribing and if you would share this with a friend who you think might get some value out of it too. Thank you so, so, so much for listening. Thanks.

And don’t forget our six star rating.

Sam Jethwa has come a long way since a mishap with a paperclip first led him to consider a career in dentistry.

This week, he chats with Payman about his journey from VT in Cornwall under the stewardship of an unusually accommodating principal to his current role of vice president of the BACD.

Sam also reveals the ‘a-ha’ insights on occlusion that transformed his practice and why he is vocal about dental tourism.

Enjoy!     

 

In This Episode

01.14 – Career progression and BACD

09.50 – Social media, confidence, and communication

16.50 – Backstory

20.06 – Deciding on dentistry

25.39 – London and Cornwall

33.31 – Into practice

44.56 – On occlussion

48.34 – A-ha moments

59.01 – Profile and dental tourism

 

About Sam Jethwa

After completing a postgraduate diploma in clinical education with the Royal College of Surgeons and Physicians of Glasgow, Dr Sam Jethwa has carved a career as an engaging speaker and educator on smile design, occlusion and functional success.

He is a board member and vice president of the BACD.

Tell me. Look, a. I know you can’t explain it to me in one moment. Right. But explain it. Explain it to me in a moment. Yeah, Like.

The light bulb was. Occlusion is chilling. It’s not.

Quite okay.

It’s not bite. It’s chewing.

I get it. I get.

It. I remember where somebody said to me once we check guidances into out. Well, not everyone is the same way, but if if you’re cheering to do is moving a to out to in as well. Yeah we do. So there’s not one answer to what is the ideal, but you’ve got to check it in multiple different scenarios. And the most important one is chewing, because that is what breaks your restorations. That is what what goes to show in the first place. That is the thing you’ve got to get right.

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.

It gives me great pleasure to welcome Sam Jeff onto the podcast. Sam’s a dentist. I’ve known since before he was a den Sam since he was one of the student reps at the back. I think along the same around the same time as Richard Field and Simon Chard and those guys. And it’s actually pretty painful for me watching these these young students who start out as students. And then I’ve watched them go past me. And as far as their knowledge and to what someone like Sam go from student to associate to principal to now teacher and now leader at the last Sam, they became the vice president.

That’s right. Yeah.

It’s a real pleasure to watch it happening in front of my eyes. But this rate of sort of progression that, you know, you’ve got to you’ve got to accept or you’ve got to admit it’s a sort of an exponential up until the right kind of movement. Does it lead to any sort of imposter syndrome or the downsides of this sort of you must be a busy guy, number one.

Yeah. I mean, firstly, thank you for having me here. It’s it’s obviously, like you said, we’ve known each other for years, Right? You’ve known of other dentists longer. But my whole career in dentistry, I’ve known you. Right. So that’s quite big for me. I think in terms of what I guess you’re asking. It hasn’t been that long to have got to where we are in terms of what.

Did you qualify for.

2012? So you’re quite right. It was three years. My yeah, my, my kind of my back journey did start pretty much then maybe a little bit before then. And so it has been now ten years in the back. So I guess the the growth that you see and things like that, I would say it’s not been as quick as I would have liked. Not in BCD, but in terms of you and you look at it, anything actually wait, it hasn’t actually been that long because every year that goes by, I’m always thinking, you know what? What are we growing? What are we How am I growing? What am I learning? And sometimes you feel like nothing’s really happening, but it is happening. And I think that’s that’s the thing. It’s happened over the past ten years kind of quite organically and basically was fundamental for me for that because I wouldn’t be doing any of what I’m doing in terms of dentistry or even in life, because that’s what the industry has given me. If it wasn’t for that academy and it wasn’t for being pushed at that young age of actually going there. And I remember the first ever conference was I can’t remember where it was now, but I was I was alone. You know, I knew of people that these are these names. It’s like the owners of Enlightened, right? They are incredible. And then you have Chris, all who everyone says do his do his course. And I did that straight after tea. And and Tiff Qureshi at the time, who I think was Zach and Tiff and they were like vice president, president or something like that at the time a.

New.

A new and rather Doshi was was up there as well. And some of these people that were doing incredible things. And James Gornick is somebody I always every time I’m at conference and he lives actually just down the road from me, we bump into each other. And I always say to him, you know, you were one of the pioneers. And I said, I still do. But at the time I used to look up and think, Wow, how have they done that? It seems impossible. But if it wasn’t about being around those people, I really would not have known what on earth to do with my degree or where to go or what to say, where to take it. And I remember sitting at one of these early conferences on my own, and people like that would come up to me and say, Hi, Joe Bansal. I remember him very, very clearly. One of the nicest people in dentistry.

Good, great guy.

Such a genuine guy. And he came up to me and he was like, Oh, is this your first conference? He started talking to me. He didn’t need to do that. And that is what I always hope still happens at conferences for the young ones, because that changes your life. Those conversations change your life.

You know, I was doing a podcast from the back. Wasn’t that you were too busy to, you know, around you’re running around. But but I remember I spoke to Nicola Gore and she said something about sort of the responsibility of the veterans to make the newcomers feel welcome, to have them keep coming, which I never I never thought about it as a responsibility in the way that she was saying it.

But it’s interesting.

But having seen your journey and Simon’s and Richards and so many others over the years, when I talk to the student reps now, there’s a part of me that says, Is this going to be the.

No, I don’t think I know. I’m Simon is the president this year and I’m the vice president. And we started that journey together, the both of us. And for us to both be here now doing things like this, it’s for us. It’s really special, actually, the two of us, because we were the same year at university and we’ve been friends since before this. We were friends. And Megan, Simon’s wife is really good friend of mine through through our university years. So to do this kind of together is special. But I never, ever had the ambition that I would become the president of the British Academy of Cosmetic Dentistry. It was never a it was never a thing on my mind, ever. And it sounds unrealistic for me to say that now. And I’m sure people are thinking, Oh, that doesn’t sound genuine, genuinely never thought I would be in a position where I deserved it. And I think that’s what you touched upon in terms of imposter syndrome and things like that. I wouldn’t say I’ve ever suffered from. I’ve never I’ve never put a label on it, what I was feeling. But I definitely been very, very reluctant to put myself out there in situations such as at a big city conference, having to stand up at the AGM and give a short speech as to why you think they should vote you onto the board. It is a democratic process as an election. It’s not just a case of who you know, although who, you know, is part of the back. And networking has changed all of our lives. You know, that’s that’s the reality. But when you come to the board, there’s an election and the vote the members vote you on.

And I had to stand there after having seen some of my really well respected colleagues who I would think, Oh my God, I can’t believe that they couldn’t get elected to the board. Who am I to think that I’m going to stand there and be elected? So but that first step had to happen. And people around me on the base had to say, just do it. You know, What is the worst that can happen? Okay, You don’t get it. And then the next year you try again. And I did. And so then every time I’ve had to go up for re-election, I’ve been voted in again, which is great because I do put a lot into the academy, but I didn’t do it so that one day I’d become president. I did it because it was part of my life. You don’t really think about it when you’re in that deep that this is a job or it doesn’t feel like a chore. And of course you have a day up, days and down days in any job. But it never felt like that. It’s just this is what I do. It’s part of my life. And I think then the time goes on and you learn a lot about the way the machine works. And naturally it gets to a point where there’s only a certain number of board members and someone has to go for those positions. And that’s just how it happened. But now I feel kind of ready for it. But I would never have thought this is where we would be at this stage. Never in a million years.

Let’s be a nice feeling, man.

Yeah, it is. It is. It is nice. And it’s I do feel a lot of privilege and I feel a lot a lot of thanks to people that have supported me through that. You’re one of them and the board members. Because if it wasn’t for people saying to me, Oh, go for it, or you can do it, I when I was asked to take on communications committee, it was like, you know, I always saw the communications director struggle.

Because.

Running communications of an academy the size of the Bay City and amount of events and now we’ve got every single platform. We’ve got tick tock now. And I don’t understand that I am young, but I’m definitely not at the generation where everything is natural to me, so I have to run in it. I have been running comms committee for years now and I used to think that was impossible to do, but people around me said that I could do it. So you always need someone to lift you up.

I think it’s actually been a good role for you because do you remember when when BCD, one of the the name of the conference was like, like from Facebook, like thumbs up and, you know, as, as an organisation, they didn’t take on social media very quickly. I mean, the world hadn’t taken on social media very quickly. But you kind of I mean, I guess at the time people thought, oh, he’s a young guy, whatever, but you you’re digitally native in, in in the sense that you seem to be very comfortable talking to a camera. You seem pretty comfortable now. You know, I come across different people in this platform as well. So I think it’s a natural job for you. But more than that, I think you’re as a communicator, very good with your patients. Just in a 1 to 1 conversation. If you want to take that back to where does that originate from? Did you were you in school plays or like with why is it I’m a really shy. I’m really shy. Yeah. And really terrible in front of a camera. I just You’ve probably seen me for years. It’s not good. Yeah. Where’s your where’s your sort of thing come from? That strength come from.

I think if I go back to. Childhood. I’m an only child that I have no brothers or sisters. Has that shaped me? I think so, actually, because it sounds pretty sad. But my mom always told me that family, they’re here, but they’re not always here. You know, and sometimes you can’t ever be in a situation where you have to rely on someone, whether it be professionally, whether it be personally, whatever you are on your own. And that was kind of drilled into me in a nice way, in a kind of in a teaching way. And so I always knew that I had to gain a personality possibly that allowed me to not rely on others. And so I was very shy. When I was at school, I actually was incredibly shy. I wouldn’t talk to anybody. I used to find social interaction very, very scary. And I kind of had one or two very close friends, but very close friends. But I wouldn’t be the popular guy. I was never that. And so when I think it’s choice of schooling as well, my parents really I was the only one and they were both working people really struggled to pay for the fees to send me to the best school they could. But they always chose a school that was small enough that they felt could nurture me in terms of the size of it.

So I was always sent to I was sent to main prep school and then high school that was small enough, but they felt that a personality like mine that was very shy and would never be the first one to volunteer for something or anything like that would not get lost. And I think that was very a smart move from them. And so I actually started incredibly shy, but I finished my high school as head head boy of the school. Wow. Which put me into a position again, I wasn’t expecting. And my best friend Nick was my deputy head. And we basically had the best year ever. But it meant I suddenly, having gone from a normal student, had to stand on stage every morning at assembly with the headmaster and give notices, announcements, give speeches. I used to be the one that would be there an open day, giving a speech to the prospective parents and stuff like that. It was I was not given any training and it was just that was it. That comes with the role. And so I kind of at that age then got a lot less nervous about public speaking because I was still young.

You know, you’re 17 and your mind is still malleable. And so you actually didn’t feel the nerves as much as, let’s say I would now. Right. And so I think that starting point was very helpful. And then you go to university and I because I felt like I did that, I would then put myself forward for some of the student council roles and those kind of things that kings. So I did a lot of that stuff. And so then when it came to being a BCD and, and having to maybe stand there and talk to people about why I want to be a board member on stage, I probably wasn’t nervous about the speech I was giving, but I was nervous about how I would be perceived. What do people think about me that obviously doesn’t go away? I mean, I’m still human, and I think that was the biggest worry. But now because of marketing and my my videoing and you mentioned I do a lot of stuff to camera just in general, of course, it’s like the courses and the academy, but also generally to my platform, my social media platform. There’s a lot of me talking to camera. And the reason why I feel comfortable doing that is because I will never I my processes, I don’t prepare.

I have a title. And I started doing those videos because of experiences I was having in the practice and with my patients. And so then I thought, I need to talk about this because I’m sure that other dentists are going through similar things to me and they’ll resonate with it. And these are things it’s important that cosmetic patients in high expectations, things like that need to know. Because I was thrown into a position again where I was doing really high end, expensive, small make overs for people. And so I had to learn a lot about the communication and a lot about the management personalities who can afford treatment like that and have the expectations like that, how to how to use that to help them without it turning into a difficult situation. And so I learnt a lot the hard way. And then I thought, I’m going to get in front of a camera, I’m going to tell, I’m going to talk about it. And then I started doing the series of like patient expectation videos and things like that, and it’s very conversational about me just relaying my opinion. And the response was quite good. So then I thought, Right, that’s that’s actually something.

Did you did you go through a phase of being not very good at it? Oh, yeah. You straight away very good at remember. But you were pretty good back then too.

Well, I don’t. I don’t think so. You know, when you guys you guys were one of the first to embrace this video and really cool editing before these platforms. It was just Facebook, really? Then when you were doing it and you would always have the enlightened video, which is always the thing. But that’s the thing we were most excited about to do, is are they going to ask you to be videoed? And I used to have to say it like two, three times. I would I would stutter and my words wouldn’t come out. And and then you start to forget that you’re being recorded. You start to forget the camera’s there. But it comes with time. And I’m working with dentists at the moment for our academy, where we’re collaborating with other providers and people who may not do as much of that as I do. And and they’re very nervous about it. And it’s kind of like, you know, you just have to the more you start talking, it’s ten, 15 minutes. You forget actually what you’re what you’re in, and then you just it just becomes a conversation.

Take me back to childhood. Did you grow up in London?

I grew up in north west London. Yeah.

Oh, so nearby to where you live now?

Not as now. I grew up in Harrow. Okay, So further out of London.

And the experience of being an only child. You haven’t got children, have you?

No.

Would you. Would you. Would you? I don’t want to say do that to you.

But would I have an issue if that were the only one, you mean?

Yeah. Yeah, because. Because there’s some only children that I speak to say I would never do that. Would never have that my own kids. Because there was a loneliness to it or whatever. How do you feel about it? Because you seem like you’re pretty well rounded and grounded.

I feel in my case it was an advantage. It worked in my in my favour quite a lot because firstly I was had to communicate a lot with my parents, friends and things that older people. So I felt that I had to communicate at a different level. I was never treated like a child because I was not. They had to include me. I was there.

Yeah. You weren’t punching your sister in the face or something.

In the corner while they’re having an adult conversation. Yeah, yeah, yeah. Oh, if they can’t just leave me to the side. So it was like, it has to be there. So I was there. And so I guess that helped in terms of maturity, possibly at a younger age. I don’t think that’s any different now. Obviously everyone is like, I hope I’m not more mature than my age because that would be boring. So I think that helped. But then I never felt lonely. I don’t remember ever feeling lonely and very close to my close friends. And I think that they are my siblings in a way, like my school friends that I’ve grown up with since the age of 11. We actually all live in the same area within like literally 5 to 7 minute walk away from each other. And we are very close and those are my siblings. In a way, family is around, but actually cousins. A lot of us have very different lifestyles and we’re not as close, but we do keep in touch. But my friends were kind of like my siblings and said, I know what you mean.

I know what you mean. Because, you know, I’ve got loads of cousins all over the world, but some of my close friends are closer to me than my cousins. Yeah, and I see them as family. You’re right.

So the whole, if you like, if there was a hole to fill, if the number that I felt that was that, that was it was. And I think actually it wasn’t a problem. And if it really were in a situation where we had a child and we had one child, I would be perfectly fine with that. So I don’t think so, no. I actually see it as an advantage. I do my best as a parent. If that is going to be the case. It may not is to try and replicate what my experience was as best as possible.

And your parents? Dentist or anything?

No. My dad worked for telecommunications company for his whole life and my mum worked in the NHS and started as a rep from like a rep for one of the private hospitals and then a receptionist, actually a GP receptionist said right at the beginning. And then after that she worked with Imperial College School of Medicine for a long, long time, and she’s still there now where she coordinates their undergrad medical course. Oh, so that’s what she’s been doing for over 20 years now.

So do you remember when dentistry first showed up on your On your radar? Yes. I think you were going to do.

Incredibly clearly, actually. Yeah. So Jamie Popper always gets a shout out in this stage of a question because he was the I don’t know if anyone knows Jamie, but Jamie is is a great dentist who great guy is also an incredible guy. One of the most fun people in dentistry.

Definitely.

Definitely. And Jamie live next door to me and his brother, who’s an orthodontist while they were studying at Kings, lived next door to my parents at the grandma grandparents house. And I was nine years old and Jamie qualified and in his vet bought a BMW Z three, which was brand new at the time. It didn’t have a driveway and we had a driveway. And so he came to ask, my mom said, Auntie, would you please let me park my car in the driveway because we don’t have one and it’s new and etc. And obviously we were very keen for that because I loved cars. I still do, but that was very exciting for me. And I used to watch him go to work every morning at the window and I’d wave and I’d look at the car and it was it was just like, Wow, I can’t believe that’s amazing. The mom said to me in a really just without thinking, Oh, he’s a dentist, you know, if you want to call it that, become dentist. Didn’t know anything about dentistry. I didn’t really have never even thought about that. And then I think it was just a seed that was planted.

It was nothing really about the car or about anything else at that time afterwards, because I kind of forgot about that. It all then was that. Oh, dentistry. Yeah, that’s, that’s obvious. That’s what I’m going to be doing. I was nine then, so by the time I was then 11, I started my high school. It was sort of like, Yeah, I’m going to be a dentist. That’s all I wanted to do. And so everything I did in terms of work experiences and various other things through summer was always geared to put me in a situation where hopefully I’d have a good enough CV to get into dentistry at least. So that’s how it started. And then one of my dad’s good friends is with his dentist and they became friends through my dad’s a singer and they love music. And so that’s where I then went to shadow him and I would get the opportunities that very hard to get in terms of work experience. My mum worked at North Park Hospital, so that was a way for me to go into the hospital and confirm I didn’t want to be there.

More than more.

Than anyone.

Else. Lake Park Man Yeah, I can understand.

It was sort of like, I definitely don’t want to do medicine and I definitely don’t want to do a type of dentistry that puts me into the hospital. So that was, that helped. So by the time I got to applications, I was it was 100% dentistry and it was 100% cosmetic dentistry because by then I was introduced to ten years younger and these shows and I used to think, Wow. And I remember when I went to my dentist, my dad’s friend, I tipped my upper right one is still there. I can feel it. You’d never be able to see it, but I can feel it. While I was biting a paperclip and it was the most boring way of breaking a tooth. And anyway, so then I took I went to him and I said, Look, this is broken. He did something. At the time I didn’t know what it was, but now I know it was a tiny composite or a bit of bond or something. And the chip I was feeling on my tooth, I couldn’t feel anymore. It felt smooth and I couldn’t stop going on about it.

I went magic of it.

Got you talking about it. Yeah. Yeah. And I just thought, Wow, like that. And I mean, it came off. It was such a small tip that it would never have lasted anyway. But I didn’t even care that it came off. It was that. That feeling I had after that smoothness, that this is something I would learn to give people that that how happy I feel right now. And that’s when I knew then cosmetic dentistry was what I was focusing on. And obviously that’s why I went to that first base all those years ago and that’s. What.

Did you not consider leaving London for a university?

No, actually, I was desperate not to leave London. I didn’t anticipate at the time London University life. I didn’t really think about it. I was thinking about convenience and it would be easy to go home and see my friends at the weekend or go back to parents, and I was thinking about that kind of thing. And the plan was always go out live in the halls for a year, come back because I was commutable to Kings. Obviously I never came back. I ended up staying for the whole five years, which was the best thing ever, and I did love it. I really. I look back on those days and they’re fantastic.

You know, I’m having this conversation with my son right now. He’s in this GCSE year and I’m number one. Do you want to be a dentist? And he’s like, Definitely not. And I even had him at my one of these photoshoots and I put him into canals, Lamborghini, and I said, Hey, push, push the accelerator there and see what that’s like. And you know, that’s what dentistry can get you. And he came back and said, Sir, where’s your Lamborghini? All right. But number one, that but number two, the question of leaving town for university. And I ended up going to Cardiff by mistake, as in so much as I didn’t get my grades for London but I wanted to stay in London as well because, you know, at 17 you kind of think you’ve worked stuff out. And so, you know, having a good life, good friends, going out for the first time, girls, the whole thing. But actually, thank God I left. Yeah. And, you know, there’s other more enlightened people than me and you to go and have a year off.

And.

Travel travel the world and then go to university a long way away. Anyway, that question of reinvention of yourself in a new town. I’m I’m sure there’s an element of reinvention in a new part of town that exists, too. But student life in London can’t be that interesting because you’re just such a low priority in the town.

Yeah, I guess. But, you know, students have a way of finding student things no matter where you are. So we see you guys bar at Kings and Kings is listening to this. It will know about that. That’s and you had all the clubs we had on the Strand. We had we had our clubs and that was a big part of uni life. But then I actually feel really fortunate to be able to have lived in sort of zone one London as this is a very expensive place to live. As a student it was affordable because we had a student loans and back then it wasn’t as expensive. But you get a chance to learn about the city that you love, having grown and grown up in the suburbs. And now I can drive around London. I don’t need SatNav. My wife will disagree. I feel like I know the city really well and that’s from my student years. You know who gets to live on Tower Bridge Road by the river for four years? This is not normal thing. That’s amazing. And I loved that. And then my Out of London experience came in.

Oh, where did you go?

Cornwall.

Oh, my.

God. I guess if you think growing up in the suburbs of London going to Kings and then at the end of this, just before the end of the year, you get the email because it was the first year where they changed the way.

They decide where you go.

Yeah. So you have the ranking you rank.

Yeah, yeah.

And I thought I first ranked all the London and then, then I ranked all the stuff. I thought, well that might be nice where I would go on holiday. So obviously Cornwall came and then, then you had other cities up north and things like that. And I didn’t ever expect none of us knew what was going to happen. It was the first year it was 2012. We really didn’t know. And so I clearly underperformed in the interview and didn’t tick the boxes they wanted me to tick. So my ranking was not as high as I would have needed to get London. So I got the lark, the first one that I put after all the London ones, and that was Truro and Cornwall, and I was distraught. I just felt like my life was over. I would not be able to go and go there. It’s so far away. I just cried and I was on the phone to my mum and it was it was heartbreaking and how wrong I was.

Yeah. Best thing that ever happened, right?

Best thing ever. It was so much fun. I made good friends and had one, my friend. In fact, I ended up sharing a flat with a dentist called Jonny, who now lives in the Cayman Islands. As a practice out there. Yeah, with one of us. I should really be talking. Him and I met at the They do like a meet and greet with all the trainers and you get to matchmake basically it’s like a speed dating and we hit it off straight away and like, right, we’ll get a flat together, we’ll move in and, and we did it. And we had the best year in Cornwall, and I was teamed up with one of the most amazing people ever. Mark Smith, who is a does practice now is retired. He was he was my trainer and I learnt an incredible amount from him in terms of management of the practice, in terms of patients, in terms of the business of dentistry, but it’s also in terms of life work life balance. He really had it really well nailed and, and I just thought that was incredible. He knew that I didn’t want to be there initially because he actually is from Surrey and he moved down to Cornwall because they had a holiday home there.

They love going and he thought, Right, I want a better pace of life and saw the practice in Surrey and set up. Back then you could set up a new NHS practice on the High Street as you wish. So he did that and he he said to me on the first day I remember, Sam, I know you don’t want to be here. What can I do to make that better for you? And I mean, what an amazing thing for a trainer. I don’t know everyone’s experience, but I definitely know the experience of a lot of vets who went to the places I wanted to go to. And it wasn’t. It wasn’t like that. So that first question was, I want to go back to London. The answer to that question is I want to go back to London every weekend if I can, because friends are having birthday parties, this and that. And he was like, okay, fine, I’ll just close the practice at 2 p.m. on a Friday. That means you can get the 242 What.

A great guy.

Incredible at all. You can fly from Newquay, it’s a 40 minute drive and there’s a ten plus three, ten plus three flight and I did that for the whole year.

So every weekend.

Seven weekends of the year I was in Cornwall, of which one I was revising for MJF, one one of our v t and we had a birthday that we all attended and the other others were when people visited. A holiday destination. And I flew back and forth and it was brilliant. I used to because he he decided it wasn’t just me. He was going to let off it, too. The whole practice was going to just shut and he just changed that.

Oh, what a cool man.

And he and he did that for me. So I went back and forth. Now, I can’t imagine now having not lost Mr. Flight or Wonder Wonderful Cancel didn’t happen the whole whole year. And I was back and forth and I would get to London and my friends had finished work by 730. I’d be there at 730 at London Bridge from Gatwick, and it was great. And I’d fly back Sunday night and it became a routine. But it wasn’t just that. It was also then the he said to me, What else do you want to learn? You know, the clinical stuff. I don’t really need to teach you. This is NHS dentistry and you’re, you’re going to learn it. And I had incredible beauty training nurses who really taught me something. And the one thing I still do to this day, one of my nurses said, When you finish the day, just thank the nurse for sure. Just say thank you. Don’t just say see you tomorrow or bye or whatever, or just leave. Just say thank you to your nurse at the end of the day. And I still remember that even to this day. And I still obviously still do that. And now I thank the whole team. I say thank you, thank you. And leave that those simple things that from that one year really, really helped, I think shocking.

Shocking the number of people who don’t think their nurse you know, or who don’t make a cup of coffee for them.

Would I have known to have do that naturally without having had some.

Other work to do? This Marc seems like a great guy. He does. He’s great. And, you know, like you said, the idea that he helped you both in the clinical, non-clinical, the management side and then this sort of way of looking at life way of things.

And I have that right, by the way, I definitely failed on that front.

But what I was going to say was that I had a similar experience. I had a very excellent boss. I had him on the show, just one of my favourite, still one of my favourite people, and my business partner who, you know, had a tyrant. Tyrant of a boss.

Yeah.

But I’d argue that, you know, he learnt what not to do and you know, in life, learning what to do and learning what not to do are both important. Did you consider did you consider staying on in Cornwall at all or. Absolutely not.

It crossed my mind definitely, because obviously willing to accommodate me. But it wasn’t really it was always I had to come back to London. It wasn’t ever really a thing.

So where was the first place you worked after call?

After that? It was a case of sending CVS Blanket to every single practice. I mean, I’m sure at the time when you owned the practice, you probably ended up with one of my CVS.

I never owned a practice. Yeah.

Oh, did you not?

But did you what, Blanket send them out or did you send them? Send them out to people. You wanted.

Jobs. I sent it to every practice. I went to Mum’s work. We photocopied, photocopied, printed, printed, printed, unsolicited. Right? Yeah. And just sent it to everyone. And hardly anyone got back to me, I guess, because I. I think about it now. Do I open the post at the practice? Do I actually see what’s coming in? Probably that wasn’t right. And do I see the emails? Do I. I mean, I do log in now and then, but I don’t actually. So it went to the wrong people. It didn’t go to the decision makers. That’s the first mistake. The thing that did happen is, you know, it’s someone knows someone, someone knows someone. So I ended up being introduced to a dentist called Sunil, who had a practice just near Brent Cross in Hendon. I now have met these lovely, as I keep saying, these lovely people, but they genuinely are the best people. And that’s, I think really what’s helped me. He met me. He said, Come to my house, Let’s go through your CV. I don’t have a position right now, but I’m on the local dental committee, NHS in the area and I’ll, I’ll, I’ll take some copies and I’ll give them to everyone there. And I said, Oh, that’s amazing. Thank you. And we got on so well at his place and turned out, you know, that Asian community in London, north west London, the Gujarati community specifically. It’s like.

Orgy.

Everyone knows everyone turned out that his this, that and the other is cousin whatever knew this person that person and there wasn’t really a connection but it’s roundabout here and there and I think those things that did help because he then called me and I remember sitting at the airport to fly back to Cornwall, and I was really getting a bit nervous by this point because I’d only a few weeks before the end of the year and I hadn’t found an associate position and I was I had found a position in a private practice where I was doing a Saturday. So about three or four months before the end of my duty, I would fly back and do a Saturday with private practice. But it was kind of mentoring me a little bit on various things. And then then I’d fly back. So I had that. But that was a day and it was kind of half a day and it wasn’t really there wasn’t capacity for me to be there more, and I wasn’t sure whether I felt out of my depth entirely. I really have no idea what I was doing in terms of the clinical. I was really lost and it wouldn’t have been the right decision. But then I was sitting at the airport and Sunil called me, goes, Do you have a minute? Yes, because I have an associate who has decided to hand this notice because he’s he’s working. He’s going to move into private practice and I have a position available at the end of next month, and I just couldn’t believe it.

His own.

Place? Yeah, his practice in mixed practice in London. And I started there straight after, pretty much straight away. And that was where I stayed right up until that transition. Then I transitioned. I really like a day at a time into private practice in around about 2016, early 2016, and then a little bit before that, possibly. And then and then that became fully, fully private about a year and a half after that.

Where was the where were the private practices?

And then and then and then it comes down to BCD, because this is where I got a call from or a message, I think, on Facebook from Rahul Doshi basically. President, you had a practice in Hertfordshire, perfect small studio, beautiful place, which was, if not, is the pioneering practice, I believe, for, from what I know, 20 or 20 plus years ago, bringing cosmetic dentistry to the UK. And it was sort of the founders of the BCD and then this sort of Larry Rosenthal inspired practice that I was introduced to at that time. And I remember this and I’m sure I won’t mind me saying I remember going to the interview and this is I guess it’s the imposter syndrome. Again, something I felt like I wasn’t ready. I felt like I wasn’t ready for it. I also felt an incredible amount of loyalty to Sunil and my practice in Hendon, and I was earning well as a mixed practice and I was happy. I didn’t really know what else was out there for me, and I felt that I was and I dragged roll along for six months. I was like, Yeah, yeah, I’ll give you a starting date, I’ll give you a start date. And meanwhile I was plucking up the courage to like, almost like breaking up with my, like my uncle.

So now.

I’m leaving. And I just felt like, oh my God, I can’t. And I asked everyone, is this the right decision? People who wouldn’t even be able to help me with the answer I asked like, should I do this or not do it? And I was really worried about my income. I said, Now I’m earning a decent amount. I’m happy. I’m worried about that. What can he say other than don’t worry about it, The system here will help you.

And did you not have insight into what kind of earnings you were going to make at Raffles?

Yeah, but only from what he would tell me.

Right. You weren’t sure? Yeah.

And how do I know what to really believe? I know he, you know, and there’s that suspicion that comes in, like, why is he asking me? I remember the interview I said. He said to me, Why do you want to work? And that like, I don’t want to work you asked me for it.

Was Laura Horton there at the time. I know she’d, you know.

And, and then and that was the that was the reality. It was sort of like I really did feel out of my depth again, another stage in my life. I felt like I said to him, But why did you why did you ask me? You know, there’s truly more qualified people. I’ve done Crystal’s one year, which is an overview because again, I’m not confident in every aspect.

Had you done Rahul’s course?

No. He had stopped his course by then.

So was just back. He’d.

It was just VCD and other courses through CD. That was it. And in Cornwall I’d done Jason Smith and stuff because I was shadowing him every week because, Oh, where are you Road from him. And again, Mark, let me do that because he knew that’s what I wanted to do. So there were things that I had done, but I didn’t feel confident with it. It wasn’t using Rubber Dam to put composites on it, but if I did, it would be like a struggle to put it on and I was still really inexperienced. I’ll go into a private practice where they’re doing full month rehabs and stuff. That makes no sense to me. I can’t do that. So it took six months for me to agree to do a day at the studio, and that then turned into another day. Another day, and it turned into five days.

I mean, Perfect Smile Studio was a real pioneer insomuch as it was an It’s Hertford, isn’t it?

Hertford Yeah, it’s not London, it’s not central London practice.

It’s not like I mean, look, if you talk pioneers, I think I think Surinder in Knightsbridge.

I used to watch on ten years younger, right? Yeah, me on TV.

He was as far as that shop front, cosmetic dentist. Of course there’s been cosmetic dentists in the West End for yonks for 50 years. There really has. But as far as that question of being sort of out there right in front of people, but what was amazing about Roland and Place, and I think both of you were there was just Rollo’s place, was it? Yeah, Was it was in this middle of just this regular town in Hertfordshire. It was like I remember the first time I walked in, I could not believe they’d done that in this location. And I remember Laura Horton was the practice manager when I first went there and just so well run, man, just so well run, you know, they, they just knew something that everyone else didn’t in so much as they just went for it. They said, We want to be the Rosenthal practice of this this town.

You.

Know, impressive. And Rollo’s was a great guy. I mean, he’s a good teacher.

And that’s what then introduced me to this level. And I created a bit of grief. I’d get treatments wrong. And I remember I would refer me things and I would be again, so like not skilled enough to do that. And, and it would create problems because some things had to be redone. And, you know, I wasn’t great at this stuff, so I felt I needed to up my game a lot. Went out to RCD Did Jamie put on a DSD course on a yacht, which some people are Christian coachmen? And I learned a bit of that. That was incredible. And just kept. I used to spend all my money on courses and holidays at the time. That was it. And I was earning more than my friends were. Right. My friends are now partners at law firms and from the school friends who’ve done really well. But at the time everyone starts off a little bit lower income levels than dentists do. And so we have spare money. So actually I even say that now to our academy dentists look put, put that on towards your education because that extra worry that’s you go to self invest and that’s what I did and I begged roll please run your course once more just for me and said look I’ll make your life easier because you won’t have to sort of have to keep fixing my stuff and and it will mean that I can learn properly. Like it’s one thing to go in and watch someone doing something they’ve been doing for 15 years and come out of it and be like, Wow, that’s amazing. But you actually don’t learn anything. Yeah, they make it look easy because it is easy for them by that stage.

So what do I get out of that? Like other than being an all of you? Well, not actually that much. So I needed to make the mistakes. I needed to learn the hard way, but I needed a I needed a workflow. And so I begged him to please teach me about occlusion or whatever you knew about that, which is one of the big things he used to teach on his course. And so I did that and he kind of rallied. It goes, He’s my implant guy now who I met there. He had already done the course. All said, Do it again, Sam, Let’s do it. So let’s do it again. And then we’ve got a couple of other people in. And we had a small group and that then clarified a lot of things for me that were clinically confusing, specifically occlusion. And then I went and did more and I met some mentors of mine. And on that course that Shramik organised on the yacht, there were of course trained people, extreme expense, and I met some people there and Sandra, who like is in who’s in Hong Kong, she’s a course mentor and I think she may be accredited. I don’t want to say the wrong thing, I’m not sure, but she remotely helped me a lot from from Hong Kong. She I would send her cases and pictures and she would reply and help me with what? Do. And combining that choice kind of occlusal principles with some of the stuff that Rahul was, was teaching me as well, and then making the mistakes and learning and doing indirect work so much. I then kind of figured out my way and that’s how it started.

Tell me, look, Occlusion for you, what was the aha sort of moment with occlusion? Because, you know, we all think we understand a bit of it. And then the more you look at it, the more the less you know and all of that. But specifically, especially with the work you’re doing, yeah, it tends to be anterior indirect, Right. Most of what you’re doing. Yeah. So you’ve got these shortened teeth, something shortened those teeth, right?

Yes.

Just I know you can’t explain it to me in one moment. Right. But explain.

It.

Explain it to me in a moment. Yeah.

Like the light bulb was. Occlusion is chewing. It’s not.

Quite okay. It’s not the mood function.

It’s not fight. It’s cheering.

I get it. I get it.

That was then. Oh, right. Okay. We move our teeth. I can’t remember where, but somebody said to me once we check guidances into out, but we chew. If not everyone feels the same way. But if you’re if you’re seeing a jaws moving you tune out to in as well. Yeah. On another we do. So there are not there’s not one answer to what is the ideal, but you’ve got to check it in multiple different scenarios. And the most important one is chewing, because that is what breaks your restorations. That is what got those teeth show in the first place. That is the thing you’ve got to get right. So checking, chewing passes, understanding that, and then training our eyes to see it. Even before the patient said a word. You know that casting this is a category. The way the way I teach at the academy is we need to categorise the bite. You see someone look at their teeth, right? They chew like that. Then you go to confirm it, doing the test and then, you know, right there, this type of chew, this is not workflow, whether it’s a rehab, whether it’s veneers, whether it’s bonding, whether it’s also I’m seeing a lot of cases constricted is also being done and not enough IPR or not enough debt and things like that. All that stuff then came from that light bulb which was occlusion is chewing vision is not.

It’s very interesting thing to say, you know I’ve never heard it said like that before that out to anything particularly very interesting. It’s actually very true now that you think about it.

So that that’s changed that change everything for me because then it was all the stuff I knew how to layer composites because I’ve done Jason Smithson’s and I’ve done I was not have been on deep and things like that. So I’d seen these things, so I knew that. But what I didn’t know is I couldn’t say to my patient that is going to last or that is not going to last. And why? Yeah, I remember being in the practice in Hendon and one of the dentists there, he’s the founder of that practice. He was nearly 80 when he retired. He loved dentistry. He was he still is fit as a fiddle, amazing guy. And he was saying to his patients, don’t worry, that is going to be absolutely fine. It’s going to last few years. And me having been graduated 2012, rolled up with defensive dentistry, how can you ever say that a patient is going to last years? And what if it doesn’t? And I used to sit in my surgery because my surgery’s next to reception. Hear him say that. Oh my God, How is he saying that’s such a mistake? You can’t say that to a patient. We’ve been told never guarantee anything. Never say anything is going to last. Because, you know, But now I do say that and I’m confident in that. I can sit there with a patient and say to them that this treatment that I’m going to do is going to give you this amount of predictability.

I love I love I love the way you came up with that Aha. On occlusion. So let’s let’s continue with the AHA’s. Maybe we should have a whole section of this podcast called Aha. But look for me, I did a lot of veneers by the way, because back in my day there, that was the only thing that you could do, two years of train tracks. And I was at the very beginning of the Rosenthal, you know, hang out with Larry in New York and all that stuff and. I never had to do it. I didn’t do anywhere near the number you’ve done. Yes. So let’s let’s get a get that clear first. First of all, I did maybe, I don’t know, 40, 50 cases in total. Beginning to end. Yeah. Now, I never had any fall off. Yeah. I never had any chip in the short period that I stayed around, by the way. Yeah. Because I wasn’t there for that many years. But staining. Yeah. Staining was my. Aha. On, on veneers and specifically in the proximal staining because you know the, the recession type staining and I know there’s things you can do about that but into proximally and you know the extending, extending the prep a bit further proximally Right. So that you wouldn’t have that problem. So something as simple as that. Now later on I was doing all of this just, you know, off the back of a Larry lecture later on. You know, you watch Gallup talk about bonding to enamel and not dentine. I wasn’t doing that. I was I was prepping it. The more you prep, the easier it is right to make it look good. But but when when you hear the stats on on the survival rate of the thing while you stain enamel and then the minimal prep through the temporary and all of that. I wasn’t thinking about any of this stuff. Right.

Yeah.

But in my short crappy little career in porcelain veneers, staining was my. Aha. Yeah. Give me a couple of yours. You a couple of years. I know you have a whole course on it and let’s not let’s not let’s not be silly, but couple a couple of things regarding I know prep regarding small design.

One of the things I would say is I make I hand make my temporaries go to. I don’t have whacks ups unless it’s a specific type of workup I need for a rehab and then it would be sexual and all this sort of stuff for that. We don’t need to get into that. But in terms of you asking for like a light bulb moment, yeah, my goal always is to give my patient the best possible version of their smile, right? Not a new smile that has been transplanted onto them.

Hence, peace broker.

Exactly. That’s where the name came from. This fake smile. Right. And that has been a shift in what patients are asking for. I don’t think Michael APA is one of the people who’s who’s created that look incredibly well. And it looks so attractive and it’s all it is. Millions of people see it on social media and people are seeing that. And Dennis is trying to have started to replicate that. Patients are starting to ask for and of course, it’s regional. My my patients specifically tend to ask for 90%. They want a naturally perfect smile. That’s why it’s on my Instagram page and you scroll, you’ll see a video called Natural versus Perfect. What does that mean? What are those words mean? So my goal is always to try and create that. If we ask a lab for a waxer and we say to the lab, wax up 5 to 5 veneers, please. And we’ve all been there. What on earth are we asking for? Whatever’s going to come back will be the lab technicians Best attempt. It’s never their fault because you’ve given zero information of what they think 5 to 5 veneers should look like for that patient. They’ll base it on if they have photos. Great. They’re based on the model and then based on golden proportions and ideal length. I went to a lecture recently where someone mentioned still 11 millimetres should be the height of the central absolute nonsense that is historic and the height of the sensor should be for the rights of the patient. It might be eight, it might be 14. It’s going to be according to what they’re showing when they’re talking or smiling, all that stuff. So there’s no parameters like that that you want to stick to, but that’s what the tech will stick to. Then you get the wax up back and you put it in the mouth and you have basically a new mouth to work with. And we all know as cosmetic dentists to get a good smile to look great is much, much harder than getting a real mess to look.

Average right to go to a plus one rather than a zero, right?

Exactly. And by asking the lab to just create your wax up with no information and no guidance or even a little bit of guidance, you’re making your life much harder because then you have a good smile to improve upon. And I found that that’s what I was I was doing. I was getting these wax ups and I was having to adjust. And then I was adjusting and I was adjusting wrong because my hand skills were not there, my eyes were not trained. I was doing that wrong and I was messing it up. And then I just realised that why don’t I just start with the pre-op and IV treatment plan the case with the patient or on my own saying this is what I need to do from the pre-op, so I need to add length there or I need to bulk that one out or I need to rotate that one. That is all useless exercise. If you’re going to get a wax up that is doing something else and then you have to retreat and plan. But you were planning in the patient’s mouth in the chair, which is really not what you planned for. So you do all the planning and it’s pointless. So I just thought, I’m just going to start from the beginning, from the pre-op and then use floatable composite to shape each tooth to be what I want to be as an enhancement of the original shape and actually ended up finding that easier to achieve my desired aesthetic. What I was wanting to create. I want my cases to look a certain way generally, and luckily my patients tend to share that. And so that’s where I then started that technique and that was.

Do you teach that?

Yeah, that’s, that’s one of the.

Is there not a degree of like composite artistry that you need to have to, to, to be that guy. Or if you got a technique that you can teach easily to people.

There is a technique and everything comes with system. I’m very system based in the practice, I’m very system based in life. I try to be a system based as I can and consistency and habits. And I’ll always do a trial, smile the same way, but always start with the same surface. I’ve always put the same line angles in and it creates a consistent workflow and that is what we teach, because there’s no point me teaching someone something that they’re only going to be able to use if they’re super talented.

Run me through it. Run me through it. What do you do so well?

It would be based upon the small design that we’ve decided before.

So how do you how do you get that? Do you draw on an iPad thing?

Yeah. Is all of mine on the iPad? I don’t use any kind of softwares or anything at the moment because again, I’m still finding that template and teeth are what’s in the libraries on digital. It’s design, so you’re just swapping one issue for another issue. So until there’s some kind of I can’t imagine how it’s going to work until someone can be in my head and create the shape of that tooth that I’m thinking of using something digital, then I’m not even going to transition to digital wax. So I think is this is also equally compromised from what I want is starting a new starting point that isn’t it’s harder for me to rectify.

So interesting. I used to draw on the TV in a black marker pen. This is before iPads existed.

Well, I used to print them out. That was something wrong to me. Print out the photo and draw on it for the iPad.

Nice to draw than the TV. Yeah.

The drawing on the teeth is is perfect.

The TV. The TV. And then my nurse would wipe the TV.

But yeah, that’s, that’s, that’s how we did it. So based on the smart design but it’s always central.

So you just the dswd isn’t really part of your work then.

No.

Not even like in a marketing sense. It isn’t like you don’t think that’s exciting for the patient, that that’s not the business you’re in.

We definitely have it because what people need to know is that also, yes, I place the veneers, but that doesn’t mean every patient that sits in my chair gets veneers. That’s not I mean, that would have been the case, you know, immediate orthodontics and those sort of phrases. It’s out of the window. And if that’s not justifiable, I could not sit here and lecture and be a genuine person advocating minimally invasive, indirect work and teaching that if really behind the scenes, I was prepping everything to death. That is, I put nearly every case on social media that I treat and people see it all, so there isn’t really anywhere to hide. And that’s why we have a clinic where I have Corinne and Lydia, who are my associates, who are restorative associates, who’ve done the trainings. And I know that if I send them a case that is not right for veneers, that will be an Invisalign treatment or something like that, they’re going to treat it with the right occlusal principles because that’s what we all follow. And so they’ll do that kind of work for those patients if they’re not suitable.

I always think in what is a veneer case, what is a what is a composite case? There isn’t You can’t categorise patients into that. It’s they want. We have tools in our toolbox of which bananas are one, Invisalign is another, whitening is another, icon is another. There are so many things we have to then pick and choose and come up with a recipe to get that patient what they want by balancing what their budget, their expectations, what its expectations in terms of also can they handle that kind of work. Right? Because to go through a porcelain smile makeover, they need a lot of patients need a lot of management, either from me or the dentist, or maybe they’re not quite there emotionally for that kind of permanent change. So you have to kind of tailor it. So I don’t think there’s a one size fits all. We have so much available now should be using everything and there’ll be a mix and match is you need a team really nowadays you can’t be relying on a one trick pony. You cannot do dentistry now cosmetically well.

I mean, I notice you out there in in the magazines and you were recently on TV. I saw.

Yeah.

Is that like, if you got a PR company, What are you doing regarding that? I mean, okay, you’re the communication king.

I think it’s come to a stage now where we have to find ways of putting yourself out there. We have to find connections. I have to. I’ve been part of this within dentistry, within dentists, what I would call a porcelain revolution, where it fell out of favour for the right reasons. And now it’s come back into favour because for those reasons that went out of favour have hopefully been rectified nearly 100%. So we’re now talking about minimally invasive doing things. I need to be out there and I need to be talking about that because that I do a lot of cases right. And I feel that I’ve been through so much with my patients and learned so much about how these patients who want this treatment and go through this treatment think and feel through it. I should be out there and I should be talking about that, especially when we have things like dental tourism marketed to dentists in this country. I’m sorry that patients in this country I was on the tube yesterday. We went to South Bank with some friends.

Who thought he had.

So bad.

For painful.

I couldn’t believe it, you know, and that’s one of the things that I have to I feel responsible to get that out there because we have to educate people. I don’t want to see patients coming back and crying in our room with crowns in their hand and nothing left underneath when they had healthy teeth before. And it’s not the conversation about, Oh, I can’t afford an NHS dentist here and I have perio and I need all four and it’s £30,000 and over there it’s less. We’re talking about the young patients who have healthy teeth who are going out and getting treatments in various countries abroad. I mean, one country that we have to be very careful, apparently when we when we when we single out Turkey because we get a lot of backlash. But frankly, this is a country that advertises the most UK patients.

I mean, at the same time. Gallet Right.

And then and then exactly. I went on, I went on ITV and I, well, I said he asked me to comment on it because the VA said right. So they wanted, they wanted a comment from the academy and they came to film and, and then I put that up and I got a load of backlash on my social media about it from various people. Some people had been out to Turkey, some dentists who said, How dare you single out turkey? And firstly, this ITV’s report. I said one thing which was, I don’t believe in dental mutilation. That’s what I said and that’s what I think it is. You know, I’m not singling out anyone. But anyway, the point got bit missed. The point is, is that the patients who are going out there for the tourism are not going to see Ghalib or sell cocaine. They’re going out and seeing God knows who. And everyone is blaming us either for being too expensive or not accessible, or they’re blaming the patient for making a can’t believe someone would do that to themselves. They’re not doing it to themselves. Someone is doing that to them. Where is the attention on the people who are actually doing that, causing that mutilation to the public? Why is no one trying to stop them? That’s where it should be in my mind. And so someone did say, Oh, you can’t single out turkey. Yes, I learnt a hell of a lot from Girl. You know, so much of what I do every day is gallops principles. And the fact is that they’re not going there and I’m sure gallop And it would be great for me actually. I should reach out to him. What is going on out there? How do you feel about what’s happening there? What is it at your end? Maybe they didn’t hear about it as much as we do, because.

I hear I hear they’re just as annoyed about it as we are. I’m sure.

They are. Yeah. And I wish I would gladly say, Oh, I’m going to go. And Turkey, can you take me with you?

Yeah.

All right. But they’re not. This is the reality. It’s not that. And they’re more expensive than we are. Or if not the same.

I think, look, the real worry is there was a time where the man in the street, like the cab driver in the street, would say, I’m going to get my teeth done and I’m going to put crowns on all my teeth. And he’d be this 60 year old guy who mistakenly thought that was the right move. But at least he’d be a six year old guy.

Exactly.

Now we’re getting 21 year olds.

Yeah.

You know, and I think Qadhi said something on talk about you’re going to end up with dentures. You know everything she just said like that? Yeah, she said she essentially said, Look, you’re saying whatever you’re saying and you’re feeling whatever you’re feeling. But also consider that you’re likely to end up with dentures now because of this. And we are, as a profession, guilty of not getting that story out enough.

This is Dental Leaders, the podcast. You get to go one on one with emerging leaders in dentistry. Your hosts. Payman, Langroudi and Prav. Solanki.

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