Month: September 2023

It’s the hardest thing to do. I feel that I have done that many times. Many times, Yeah. I mean, over, you know, a thousand plus employees and you have a lot of people that are very dedicated and their heart’s in the right place, but they’re just the wrong fit for your organisation for any number of reasons, either their skill set thing or it’s the talent thing or it’s a culture thing, right? And the best thing that you can do, in my opinion, is be honest, be kind, be generous with those people and try to be helpful to them. But you have to protect the enterprise as a whole. And you have to make, in my opinion, very swift decisions as it relates to the to the personnel at the organisation. And this is why I don’t like the family analogy for companies, because you can’t fire your family. You know, I’ve tried but, but you know, a professional sports team, which is a good analogy that you know Reed Hastings uses a Netflix I’m kind of stealing that but I think it’s the perfect one because we’re recruiting top athletes and we’re expecting a lot from them and they get released if they’re not contributing in the way that we need them to. And that’s a much better analogy. That’s much more accurate, I think.

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 Tanz onto the podcast. As a serial entrepreneur who’s lately turned his hand to dentistry with Pearl AI, which has actually spun out of another computer vision, AI company called Gumgum. Computer Vision. I mean, it sounds like a crazy idea, but getting meaningful information out of digital images, I guess. Thanks for coming on the pod. Lovely to have you.

Yeah, it’s great to be here. Thank you for having me.

Sophia, give us the sort of the lowdown on someone who, you know, we were just talking of of her as someone who’s had so many successful companies, You know, your your previous one, the Gum Gum company was looking at sort of logos. Is that right? Tell us what that company was doing that led you to to to Pearl?

We did a number of things with computer vision. But generally what we did was crawled much of the known Internet every day and on an ongoing basis and developed an understanding of sort of non-textual media. So primarily imagery and video and eventually incorporated text as well, and sort of made that computer vision analysis of that non-textual data available for a variety of purposes. And the reason that’s important is because historically that’s all kind of black space as far as the Internet is concerned, because nobody’s been really able to interpret it. But it obviously contains a lot of very important information. And that’s kind of what Gumgum was focussed on doing, was illuminating that part of the Internet.

So but what were the applications?

So there were a number of applications, so advertising, advertising, targeting work that we did around sort of valuing brands and their exposure online and on televised sports events, stuff like that. Basically anywhere where a brand or a company is interacting in a visual visual medium, we were able to sort of help. So what we did specifically with sports sponsorship, for example, is we analysed every moment that a sponsorship came into view and actually quantified the value of that moment of exposure and that became a currency for brands. And Rightsholders also worked with nearly 100% of Fortune 100 brands in relation to their advertising initiatives online as you related to both targeting but also providing access to our proprietary ad formats.

And then you sort of internally incubated Pearl out of that technology.

Yeah, we internally incubated a number of different computer vision driven applications as a function of that technology. So really around 2010 or so, what you’re able to do with I started to get very, very powerful and interesting, really a dramatic shift from what was possible before. And that’s really because of the resurgence of neural networks, which are an old technology that came back into fashion and suddenly were very plausible because we had the computing power to sort of run these things efficiently. And all the craze that we’re currently seeing around AI, everything from Chat ChatGPT on down is really a function of that shift and that resurgence of this particular branch of artificial intelligence. So it became very clear to me that while we were applying this technology, you know, it’s a very successful effect at Gumgum, there were other applications that were also very interesting, and we launched a number of initiatives internally, one of which was a personal passion project of mine, which was applying this technology in the field of health care. And to radiography. I believed at the time, and I think many people increasingly believe that AI is going to play a very fundamental role in becoming a standard of care, in elevating the quality and precision of diagnoses across all forms of radiography.

So then what led you to Dental?

Yeah, so Dental is an interesting one. You know, my father is a retired dentist, so I did kind of grow up in that environment and it was very familiar to me. But we did initiate a pretty systematic review of various forms of medicine and did look at a variety of opportunities outside of dental as well. The reason that we landed on dental in the end was, you know, I obviously was already interested in it. I’m just having some familiarity. But I think more importantly is if you look at all of medicine, more radiography is captured in dentistry than any other form of medicine. You have access to data. A little bit more readily because it’s not quite as sensitive as other forms of radiography. So you have things like brain cancer and various other forms of cancer, and there’s a lot of difficulty in getting access to that data and it becomes very difficult and costly and ultimately makes it more difficult to train effectively. If you also look at the the nature of dentistry, we liked that we were not competitive with the actual customer. So dentists by and large need to perform radiographic review in order to do their job, but they’re not first and foremost, you know, priding themselves on that fact.

And that’s not the totality of their value in the world. Is it something that they have to do? So the idea of unburdening practitioners so they can more effectively diagnose, which is the first step, often in sort of, you know, identifying the status of oral health and ascribing a treatment plan to us was attractive because if you look at radiology, we and the integration of these types of tool sets there, there is a lot of concern and consternation and resistance. And ultimately I do think that these technologies do work best with both humans and machines working together. But in dentistry you just don’t have that that high, high level of sensitivity. And then those other elements on the business side in terms of dentistry being much more fragmented and entrepreneurial, you’re not selling into very large hospital groups and, you know, stuff like that. So for a variety of reasons, we thought dentistry was just a wonderful place to apply this technology. And we also believe that because of the characteristics that I mentioned, it would very likely leapfrog the rest of medicine in relation to becoming a standard of care. And I think that’s actually playing out actively today.

What stage are you at with it? Have you got regulatory approval across different different areas? Are you confident it’s better than the human on its own?

We’re actually at a much more fun and exciting stage. The past few years have been about red tape, regulatory approvals, clinical trials, you know, things like GDPR compliance, just a lot of the, you know, IP sort of oriented work as well, a lot of R&D. And those are the necessary things that you need to engage in in order to to do this properly. Where we’re at now is we have regulatory clearance across over 100 countries. We have engaged in obviously successful FDA clinical trials that very rigorously prove efficacy. We have distributed infrastructure globally, so we’re now operating in the UK, in the EU, in the Middle East, in Australia, in Canada and America and other territories. And now it’s really about distribution and integration. So the company is growing very rapidly, the technology is becoming adopted very rapidly and we really do feel like in the next few short years it will become a fundamental standard of care. So this really is in the hands of many practitioners in the operatory patient facing worldwide today.

For those who don’t know what Pearl is or don’t understand how AI works in this, could you just describe to the average dental practitioner, you know what this is from? From my limited understanding, I see it as that now. Instead of me looking at a x ray and trying to figure out is do I see a bit of decay here or do I see a bit of issue here that you can fast track me to identifying stuff that maybe my eye would not have picked up? And the more times that this technology is used, as time goes on, it becomes more accurate and more efficient and better at picking up those things, making me essentially redundant. Looking at radiographs eventually is is my interpretation close or what would you say is.

Yeah, I mean, I would start off with some data. So, you know, we ran a study with a non-profit that we helped found called the Dental Council, which is intended to study the intersection of dentistry and AI. And in one of our initial studies, what we did was we asked 136 practitioners to diagnose and treatment plan a single patients. And what you found in that study was really striking. There was almost never greater than 50% concurrence. If you looked at select teeth in the mouth, you know, it was basically a coin flip as to whether or not there was decay present. I remember two three in particular in the study. I could share it with you. It’s available on our website as well. You know, it was like 51%, you know, decay, 49%, no decay, you know, 60. Like it was a. 60 over 40 on recurrent decay, and the treatment costs came in between $300 and $36,000 for the same patient. Similarly, there was another study back in 1997. A journalist working for Reader’s Digest decided that he wanted to do a review of the state of dentistry in America, and he travelled to 50 states and got 50 diagnoses. And I think his results were something like between 0 and $40,000 in treatment cost recommendation. So there’s this massive lack of consistency. We work a lot with university partners and all the deans of all the schools of dentistry say the same thing, which is that they know that they’re not sending dentists into the field proficient at identifying a range of pathology, and they’re expected to learn on the job.

But that’s very inconsistent and there’s not really a good feedback loop there. So the need is obviously very real. If you look at our clinical trials, we were able to show that we surfaced 37% more disease on average per radiograph encountered. So this is everything from various types of caries. Obviously, interproximal are often missed, but you have things like calculus that are often missed or early bone loss or periapical lesions or margin discrepancies. The list goes on. Our technology is called second opinion, so we are a real time patient facing non human in the loop tool that is simply highlighting radiographs and where it’s relevant. Also sort of measuring areas of decay or bone levels or other sort of pathologic and non pathologic conditions that are present. And the idea is to point out those areas of interest to a practitioner so that they can make their own assessment, they can check things clinically and they can ultimately then begin engaging on a treatment plan. So at our core, the thing that we’re most known for is this tool called second opinion, which is the most advanced and the most comprehensively regulatorily cleared product on the market as it relates to this kind of diagnostic AI. We have other tools as well for practitioners that go even a level deeper that interact with the practice management system. I’m happy to talk about that, but I’ll just stop there and see if see if that’s clear.

How do you train a computer vision model and how bad was it originally? I mean, someone I’m always interested in people who I mean, you are a veteran of this, right? I mean, there can’t be many people who were in on this in 2008. How bad was it before and how quickly has it moved on? And how do you train it? Do you show it loads and loads of radiographs and humans checking up its work.

Painfully and with a lot of money is the truth. So what do you do?

That sounds that sounds like the regulatory. I want to ask you about how much that cost you.

Yeah. What?

Everything costs a lot. This is not a cheap thing to do. Well, yeah. So we’ve raised, you know, about $31 million to date and are, you know, in Q1 likely engaging in a much, much larger raise on top of that. It’s an expensive endeavour. On the training side, what you need to do is, you know, a massive quantity of representative data. So you need to have represented demographics and geographies and sensor types. You want to do things like digital radiography and phosphor plates and just make sure that it kind of covers the market generally because this technology is intended to be used in market with any sensor and any imagery that’s thrown at it. And then you very painstakingly with hundreds of dentists initially, and then you whittle it down in various ways, label that data. So you go in and you annotate it and you sort of mark up where there’s disease and you have methodologies that are statistically valid for for litigating disputes between sort of two different practitioners or three different practitioners. And that’s actually one of the challenges with with the FDA, for example, is that they looked at the data and they said, we don’t know how you can have a ground truth set that you’re going to test yourself against because nobody’s consistent to begin with. So we had to engage in a lot of statistical analysis to actually show that we were able to, over time, develop a ground truth set that was actually valid and reliable.

And then you start to train. So you start feeding it into the neural networks and you see what comes out. But what people are often not familiar with is the heavy amount of pre-processing and post-processing and heuristic rule sets that are then layered on top of that. You know, certain things might be detected by the AI that just would never make sense, right? And you can kind of eliminate those and you kind of go through that process. So, you know, is really refined on an ongoing basis. We put out models every couple of weeks. It’s always reinforced with new data when we run something. Thing through our system. You’re really running through over 30 neural networks, not just one massive one. And we have, you know, 8 or 9 neural networks that are specifically focussed on different types of carries. So as far as the machine is concerned, those are all different models. And you know, a similar philosophy applies to other detections. So when you’re dealing with a medical application with a very high bar of expectation and requirement, then you actually have to go well above and beyond what you would do in other computer vision oriented applications. Although I will say that the general methodology, whether you’re training on cars or cats or or dental pathology, is pretty much the same process.

What is a neural network? Sorry for my lack of thingy, but you mentioned that, you know, 30 different neural networks and in one particular area, say eight different neural networks. What does that actually mean?

Yeah, good question. So a neural network is a branch of artificial intelligence, right? There are various approaches to AI that have existed over the years, and a lot of them get a lot of excitement and most of them have generally kind of fallen flat of expectation. What the neural network approach is is effectively a somewhat rough but also accurate representation of the human brain. So you have synapsis synapses and axons and you have this sort of network of synapses effectively interacting with each other in the brain and based on the understanding of the human brain. Actually in the 50s and 60s, this notion of a neural network was conceived of this notion that if you just feed raw data into this network, it will start to figure out patterns in that data and it’ll start to reinforce itself toward the right answer. That’s why this is often called reinforcement learning. So basically what you’re doing is teaching a computer to understand things conceptually versus describing them. So if you think about, you know, an apple, if I tried to with traditional programming describe an apple, I would say it has this curvature and it has a little thing that looks like a twig and that has a certain colour and a curvature and it could be these colours and, you know, that’s all fine and good, but then you feed an image of a rotting apple on the ground or an image of a monkey holding an apple or an image of an apple and slices and suddenly that thing doesn’t work well at all.

So that’s just not a good approach to trying to have a machine identify where an apple is or is not. However, with a neural network, you’re able to feed in every example of an apple that you could think of, and it will start to identify the edges and the colours. And ultimately the concept of this notion of Apple in much the same, you know, I have a two year old and I’ll show him something a few times, you know, say this is a spoon, and he’ll suddenly be able to identify a spoon even if it’s 2D on a piece of paper or if it’s upside down. And he’s developed this model of spoon and it really is kind of the same thing. So we’re just developing what is the sort of model and character of a carry or of a periapical lesion or of a filling or a crown or whatever the case may be?

And so when you’re talking about 30 neural networks, you’re talking about essentially 30 different ways or models of interpreting that, bringing them all together. Yeah. And then delivering the result.

Yeah. And we have all types of neural networks that don’t even look at pathologic data. We have neural networks that determine, is this an OPG or is it a right wing or is it a periapical x ray? I mean, it’s doing all types of meta data analysis to know we do things around rotation and orientation. We’re able to understand tooth numbering. We’re able to actually segment out. This is a very useful tool for practitioners. We’re able to segment out anatomical structures so we can tell the dentine from the enamel, from the cementum, from the root, and we’re able to actually overlay that data on top of radiographs. So when you’re explaining to a patient, Hey, you really want to address this decay before it touches the nerve, because if it touches the nerve, then we’re going to have to engage in a root canal is going to be much more costly and much more expensive. Then you are communicating to a patient in a way that’s very clear, is very visual, and we actually dramatically increase case acceptance as a function of that because the patient now really understands what’s going on and it elevates the level of trust as well.

I can imagine that that side of it, the patient communication side of it, is probably even a bigger driver than I think it’s 5050.

I mean, they’re everyone focuses on the pathologic detection side. But I agree with you in that the patient communication side is just as important.

Well, you know.

So many of us suffer with that. And it’s not it’s not about dentists generally, not that great at communication, to tell you the truth. But it’s a difficult thing to see. I mean, it takes years. You know, you really don’t know what is decay and what isn’t decay when when when you’re a young dentist and then you try and show a patient and say, hey, see this little grey area here? Yeah. And most of the time they can’t see that exactly. Whereas if it was there in pink or something.

That’s actually.

Would change the.

Game, right?

That’s the colour that we use is pink.

Oh really?

Every, every detection is a different colour, but we do different shades of pink depending on if it’s enamel, only if it’s actually encroaching into the dentine and stuff like that. But you’re right. I mean when you show a patient a grey smudge on, I think that’s already confusing. They’re not really going to understand what it is that you’re talking about. So this plays a huge role in patient communication case acceptance, and it’s one of the reasons why dentists, you know, sort of love using it.

Were you surprised when you moved into the sort of medical area about how many hoops you’ve got to jump through on the whole regulatory side? Because I’m in I’m in dental supply as well, and I feel like it’s a weird double edged sword. It’s kind of the the worst thing and the best thing about being in this area because it’s a nightmare to get the regulatory regulatory right. But once you’ve got there, then you know, there’s a real barrier to entry for anyone else. Yeah. However, however long it took you or however many millions you spent getting all of those FDA and I guess, you know.

I guess we’re also the.

Only cleared product really in the market. And that was.

What about Japan? Did you manage Japan? Because that’s a nightmare for everything.

Yeah, that.

Was a very difficult and very costly endeavour. And and you know, even the philosophy behind something like Emdr is very different than FDA or Pmda in Japan in that you’re looking.

You know, did you.

Know you were getting yourself into that?

No, I don’t know anything. So that’s kind of my that’s my strength, is that I’m just naive. If I if, you know, the pain you’re going to be walking into, you might not do it at all. So, you know, I historically have entered categories that I am not an expert in and naivety helps. I knew it would be a heavy lift and painful. Of course, I didn’t know quite in which ways or how. And when. You’re dealing with so many regulatory bodies concurrently and you’re still, you know, we’re not pre-revenue anymore, but we were pre-revenue for a while. You know, that’s a that’s a it’s a stressful endeavour because you’re spending a lot of money, you’re burning a lot of capital, and it’s kind of an all or nothing thing. Like if you don’t get through, you need to start from scratch, right?

Yeah. Yeah.

Well, it’s bouncing around in my head and we’re probably a million miles away from there right now. But sort of early detection for things like cancer or perhaps rare cancers. And and I guess you need the data to feed the model, as you were describing then. But, you know, even if I go back to my own personal story, I’ve got an l5-s1 disc tear to the right, and it took three scans for for somebody to diagnose me, right? And actually, the third guy could look at my first scan and he saw it like, stuck out, stuck out to him like. Like a so, so, so how how often does this happen? In the real world. Right. Let’s talk outside of dentistry now. Right? All the time. And then and then you think just how powerful this could this be? That if. Well, early detection, cancer. Right. I mean, that would be insane.

Yeah. And that’s happening very rapidly throughout medicine. I mean, this is going to be applied holistically across the board in a relatively short period of time, and it’s going to be hopefully resulting in much better outcomes. One of the nice features of whether you’re detecting cancer or caries is in our case, we’re proving that it’s almost we’re we’re servicing almost 40% more stuff that’s getting missed. It’s a lot of stuff, right? But a bunch of it’s going to be, you know, say like in Interproximal Carry that is just an early watch area. There’s nothing that you necessarily want to do about it. You want to be aware of it and you want to take preventative steps. And that’s a nice conversation to have with the patient as well. They don’t need to do anything differently other than engage in better oral care. And if you’re able to capture things, catch things early, especially cancer, then you’re able to have much more elevated outcomes. So when you catch something is critical. But yeah, I mean, that’s a great example that you bring up.

How far do you think we are away from that?

I think it already I think the technology already exists and is sort of probably, if not already FDA cleared is in a clinical trial phase. I think there’s about 200 FDA cleared devices that are able to look at radiography and detect things. You know, mammography is another area that’s been very popular and has seen success. So it’s all happening. It will all happen. This is kind of not a question of can the machine do this? Well, that’s not an outstanding question anymore. We know that it can. So, you know, people are getting after it.

Amazing.

I saw one of your main investors is David Saxe, who I’m a massive fan of from the All in podcast. Yeah. When you I mean just on the general thing from from the sort of founder sort of angle when you’re pitching to these investors to start with, I guess you’ve got to pitch like you’re going to you’re going to take over the world. You’re selling a massive dream, right? Was the dream that you sold dental radiography I or was it I in dentistry and is that the plan?

It’s really about elevating the standard of care across the entire field. So at our core, what we do in the first step is to get this plumbing and make it a utility in every dental practice globally. But that is really just a stepping stone to a huge amount of other applications. First of all, there’s a lot of modalities. So you have the 3D realm and you have CSF. And one thing we haven’t really talked about is that we’re actually able to correlate the data that we identify in the imaging system with the data and the practice management system and identify all, you know, like all the characteristics of the entire patient population. Do a comprehensive chart review, show all the undiagnosed opportunity, show how that leads into various specialities, whether that’s endo or Auth. I mean, there’s a massive amount of interesting work to do here.

With I mean, it could.

Even go to treatment planning rather than just diagnosis. Right?

Exactly.

Absolutely. Yeah. And that’s one of the things that we do with our practice intelligence platform is we actually will colour code the schedule every day and we’ll highlight areas where there’s an action to be taken, both driven by AI and not. And we’ll list out in various funnels the various appropriate potential treatment opportunities for a particular set of pathology that are present.

Did I hear that right? Could could the software retrospectively go into the practice management software, hunt around, find all the x rays? And then pick stuff out.

Pick all these patients.

Exactly. Previous patients, thousands of patients.

We go back by default, 18 months in time. But we can go back. In some cases. We’ve done, you know, 5 or 10 years and we basically highlight the characteristics of that patient population. So that’s where we’re actually starting to cut the stake for the practice, right? And that tool set really services management, IT services, front office hygiene and GPS. So you’re not just providing real time detections, you’re actually taking that analysis, you’re correlating it with this other data set about the characteristics of the patient and the other work they’re engaged in, what’s planned, what’s been scheduled, the notes, all that stuff. And you’re holistically bringing it all together.

Tell me about the sort of the offering to the dentist. Is it is it the monthly subscription? Is that how they pay for it? Does it integrate with the software? There? Practice management software? How easy is it to sort of onboard? You know, a lot of dentists are tech savvy, but a lot aren’t, right?

Yeah.

So it’s a monthly subscription, we think quite affordable relative to what we’re surfacing. In other words, typically, how much is it?

How much is it?

So I’ll give you the US dollars. It’s 299 US for second opinion per month and 595 for practice intelligence. However, we are surfacing typically thousands of dollars per week in incremental restorative opportunity, for example. So really you can pay for this whole thing, you know, within for the year, within 1 to 3 weeks. I mean, it is a is a big sort of production oriented ROI there. And we intentionally wanted to price it very accessibly because we do believe that this belongs, you know, in all dental practices globally.

And is that is that a per practice stroke per clinic fee or per practitioner or how.

Does that work? That’s per clinic, per practice.

So it doesn’t matter if there’s 20 dentists working in there or five dentists working in there. It’s a flat fee basis.

Typically we’re not really, but there is a limit at which if you’re like, you know, 30 operators, one of these kind of outlier practices, you might pay for a few licenses, but we’re pretty generous with the image counts. So I would say up to five practitioners. And then, you know, you might kick on another license. But if you’re a DSO and you have 100 locations, that’s 100, you know, typically 100 license.

Of course, of.

Course. And then what’s the distribution model? Are you I mean, have you got your own sales team in the US and you’re working with distributors abroad or how are you doing?

Good question. So basically, we have a variety of ways to access this technology. We have our standalone tool for second opinion, which integrates with pretty much every major imaging system and PMS out there. So you can just kind of subscribe and use this tool. Increasingly, we do have partnerships with a range of PMS and imaging partners out in the market and they’re engaging in more deep integrations where you’re able to actually access these capabilities just natively within your existing interface. So just one example of which there are many, you know, would be like Planmeca. We did a big announcement with them and they are integrating these capabilities into Amex’s you natively and directly so you don’t even have to go to another interface. You could easily turn it on. And from a distribution perspective, we have our own sales team both domestically and globally, but we also work with distributors in the UK. We work with Dental Directory, for example, and you know, we’re working with the various sort of channel partners to get the thing distributed.

I’m really curious about your backstory, right? I mean, I’m just sat here in awe blown away by what you’ve done and what you’ve achieved. But tell me a little bit about your backstory. You know, where you grew up, what sort of school you went to, what kind of kid you were, and how you managed to navigate to to where you are today. Were you were you some computer programmer type kid? Just just talk me through. Talk me through your upbringing.

Yeah. I’m actually very fortunate in that, like, I knew, I think from a fairly young age what my interests were and how I could apply them. So I was probably 13 or so and I was like, I think I’m going to run venture backed, you know, tech tech companies. And it was very much a programmer, sort of obsessed with all things technology and specifically programming. And that’s ultimately why what I ended up studying and I got my bachelor’s and master’s at Carnegie Mellon and it was just very clear on what I wanted to do. So I really feel like I’ve been at this for since I’ve been like 14. Wow. I actually started a company in in high school, which is kind of a development oriented interactive agency and, you know, sold that. And it’s kind of a. A typical story for people that are often sort of do what I do, which is you kind of identify young and start young and have the entrepreneurial bug. So for me, it was never really a question. And yeah, still, I still love it. I’m still fascinated by it. I don’t actually, you know, have hands on keyboard sort of programming day to day. I moved away from that quite a while ago.

When you were about.

15 or.

No, no, no.

It actually.

Did work.

I did. I did have one job in my life, um, working for a hedge fund. I worked for a hedge fund called Bridgewater Associates out of college, uh, out in Connecticut. And I was a programmer there working on trading systems and whatnot. Did that for like a little over a year. And, and then I went and started a company and then I’ve been starting companies since.

Wow.

Okay, you don’t need to do this. What drives you now? I mean, surely the previous, you know, the gum gum success story, you could be sitting on a beach.

Yeah, it’s a good point. I mean, I’ve actually been having this conversation. I don’t know that I will do it again in quite this way because it’s so much work and it’s it’s a pretty painful process. It’s never not hard to start a new company, especially when the expectation is to frankly, you know, quickly grow to $1 billion valuation and more. I mean, that is the hope and the expectation on the part of the financial backers and also on my part as well. So it’s a very intense sort of all consuming process and it’s probably why a lot of people in their 40s, you know, that have had success in their past, stop starting companies and go more so to the investment side or or do other types of work just because it is so consuming. But in particular with Pearl, I really felt that I was sitting in this very unique position where we had a lot of proficiency with this technology. It was very clear that this technology was going to have a massive impact on humanity and on medicine. And I just wanted to play a role in in sort of applying this technology to more impactful and meaningful effect. So I’m very proud of what we did at Gumgum. But a lot of it was selling advertisements, you know, and I became known as like a media guy, and I never felt like a media guy ever. And at some point I was like, okay, I think I just need to do something different before, you know, my career becomes a different kind of thing. And I did go to the board and I pitched him on the idea of spinning out of me going and running it. And, you know, that was surprising. And there was resistance to that concept because it was unexpected. But I think we created a scenario whereby it was it was very win win to go and do something that I thought would impact humanity more fundamentally.

So listen, going forward, then, what are you looking at in sort of a five year horizon? I mean, do you feel like your job will be done by then or how long will it take?

I don’t think the.

Job will ever be done. I mean, we have probably a five year roadmap that we’re engaged in. There’s a lot of obvious work to do, and then there’s less obvious work to do. But it all effectively revolves around how can we apply different forms of cutting edge AI and technology generally to help elevate the standard of care in dentistry and to help unburden dental practitioners? You know, dentists in particular have very, very stressful lives. My father I witnessed this, right. So you go to dental school, you become hopefully a good at practising dentistry, but suddenly you need to find real estate and you need to run a business and you need to do hiring and firing and you need to do back office and accounting. And it’s just a lot. Yeah. And, and.

You’re working, you’re working in it, not on it. That’s, that’s really a.

Big problem.

In it. Not on it exactly. And that’s just a lot. So I think that technology can be brought to bear increasingly to just help unburden practitioners and also elevate the standard of care for for practitioners, for for the patients.

What would you say is your superpower? I mean, how many how many people did you end up having in Gumgum?

Oh, uh, gosh, probably when I left around 650 or 700 or so.

700 employees.

Well.

So so so as a as a CEO, I guess you’re spending a bunch of time raising cash, then you’re spending a bunch of time selling the vision to everybody, Right. Including internally as well as externally. Right. What is it like? I mean, you’re you’re clearly a technology, you know. King as well. What is it about you that you know from your from your the way that you’ve worked, that you think is being your superpower in getting these companies off the ground, billion dollar valuation, so forth?

I think that is my I like building companies. I like taking ideas and making them a reality. I think when companies become about more so operational driving, operational efficiency, I get a little bit less interested. That’s definitely the stage that gum was at two. It’s just.

Like.

I don’t think I’m the best person at that, first of all. And I also am not the most interested in that. I’m more interested in 0 to 1 than 1 to 5, although it’s much more fun to be in the 1 to 5 mode because things tend to be sort of working and humming in in relation to raising money. For Pearl, it was a really different experience than gum. So gum gum we raised like, I don’t know, $130 million or something. When I raised my first, you know, 500 K, I was a nobody and had to pitch everybody and kind of sell the vision and and had to do a lot of that. And because I have a reputation and we built a successful company at Gum gum and have relationships raising the money for Pearl was one conversation with one person, literally did not speak to anyone else about it. So Dave David Sachs came to my office to just check in. Yeah, it was. It happened to be around the time where I decided to do this spin out and I was like, you know, Hey, I’m thinking about doing this thing and spinning out this company. What do you think? And he’s like, I think you should do it and I want to back it. And let’s just agree right now, like, name a price. And we shook hands and he did it.

How much did he give you?

How much did you give? You was right at the.

Beginning, wildly.

Easier when you have relationships and some success.

Under your belt. How much was that for? How much?

How much did he give you in that handshake?

11 million.

Before before you had.

Anything? No, because we had.

Incubated the idea. So we had some technology and some proof of concept, but we didn’t have much, to be honest. And frankly, I was probably overvalued relative to what we had pretty significantly. But he had faith. And his perspective is, you know, back good people back, good ideas, backed big markets and good things will happen, hopefully. And subsequent to that, we’ve brought on a number of other premier investors and it’s actually been incredibly easy and they’ve actually come to us. So that is not the typical story. I’m definitely very sympathetic to the other side of that reality, which I spent many years experiencing firsthand, but things have become markedly easier in that regard. It also helps that we’re doing this thing that everyone’s excited about in health care. So it’s a very bright spot within tech right now.

Yeah, as in as in from the from the investment perspective, people are still willing to invest in AI and health, whereas they’re not willing to invest in a whole lot of other tech, Right? Is that what you mean?

Correct.

It’s been a difficult it’s been a weird go at the whole from a market perspective since we launched Pearl because we had Covid and that was, you know, crazy. And then we had a bit of a financial meltdown. And, you know, then getting to the hopefully what is now a recovery. It’s been a very odd set of realities on a macro level.

So yeah, let’s get to the darker part of the podcast. We like talking about mistakes on this podcast, and a lot of times with dentists we talk about clinical errors that they’ve made. When I say mistakes, what comes to mind?

Um.

I mean, as it relates to Pearl in particular, I just think that the jury is still somewhat out on it. In other words, we received our FDA clearance in March of 2022. We’ve been commercialising to great effect since then and we’re growing very, very rapidly now. But I think that we have taken a certain strategic approach to the market that is ultimately going to determine how successful we are, you know, relative to anyone else engaging in the space. And I believe in our strategy and I stand by it. But I might find that there were some real errors there because you can’t do everything at one time. You have to kind of pick your lanes. You have to pick your distribution channels and you have to pick your partners and you have to pick the technology that you’re going to focus on, the problems you’re going to solve. There’s a lot of decisions that go into that with very imperfect information. I’m sure we didn’t do it perfectly, but I think that’s really going to sort of the mistakes that we made will rear their head over the coming years, and it’ll be more clear than right now. Right now, it’s such a greenfields opportunity. There’s so much demand, it’s so new, the market is so ripe that it’s hard to really tell. I can get into certain approaches that we took technologically, which ended up being dead ends, but that’s.

The price of progress. Yeah.

Yeah. So we took certain approaches technologically from a from a machine learning and training perspective that, you know, we’re, we’re wrong that we had to backtrack on and do better. I think that the way that we approached regulatory was, in retrospect, incredibly bold with the FDA. For example, we went after ten clearances at one time. Wow, nobody’s ever done that before. It ended up working out, but I think it was also a big risk to have to have done it that way. So I don’t want to say we got lucky, but it was definitely a risk and that was a function of not really knowing on some level what we were doing, even though we were sort of advised, I don’t know. I don’t want to I don’t want to give you a I don’t want to shy away from the answer.

I just had a mistake. It Yeah.

If you have ever had one of these as an entrepreneur. Right. And look, I’m a very small business owner, right? But I’ve had numerous falling down moments, right? Oh, shit. I’m in. I’m in the deepest, darkest hole. Right. How the hell am I going to get out of this, right? Emotionally, emotionally, you’re in that space where you don’t know whether to cry, laugh, break down, whatever that is. If you ever had those moments and what were they and how did you get out of the hole?

Oh, so many times. I mean, so often. So. So I’ve had those moments a lot, which is why it’s such a difficult and miserable endeavour to start a company like this. So with Pearl, it’s an easy one. I mean, there’s been plenty of those moments, but, you know, the most obvious one would just be, okay, now we’ve spent, you know, X amount of millions or tens of millions of dollars, and if we don’t get this regulatory clearance, we literally cannot operate. And I will have failed. I would have lost all the investor capital. I would have been a fraud and all those feelings, Right. And then that same thing comes to bear when you’re entering new countries and big partnerships or, you know, there’s just, you know, while we’re doing well at the moment and everyone’s very excited, like it does not feel like we’ve punched through into being a big company by any stretch. So that’s a very familiar feeling. It was a very familiar feeling at Gumgum. It’s all the same exact feeling. Everything that you mentioned, Yeah, it just coming in different in different forms. But yeah.

You’ve got a two year old kid, was that right? Did I hear that right? Yeah, yeah. Just talk to me about work life balance and what a day in the life of fear is like and how do you balance your duty and your role as a father and making that time and space. Maybe you’re one of these guys who manages it incredibly well and what a typical day looks like and how you manage your time.

Yeah, well, my partner, she’s a she’s a filmmaker, so she’s a writer director. She actually just made a movie. So she’s been in the editing room for the past three months. Every day. Yeah. Um, I actually so in during Covid, we became a remote company and that was actually pretty functional for us. There are some drawbacks of it, but while the majority of the executive team is in Los Angeles, we now have people kind of everywhere and we operate very remotely. So I do primarily work from home, um, which has actually been wonderful because that means I’m able to see my kid a lot in a way that I never would have been able to before if I was working. Pearl Like hours from an office, that would be difficult. Um, so that’s been a really nice feature of that reality. I’m able to pop up and, you know, spend 5 or 10 minutes and that makes a big difference. I would not say there’s a, it’s a I would not say there’s a very good. To work life. It’s kind of always the work is always on. I’ve gotten good at separating the two, at not letting you know the the current feeling about about the company sort of overshadow everything else, which is a skill you have to have, I think if you’re an entrepreneur, but it also makes it so that you know the two year old, it’s such a fun time and they’re so joyful and they’re so cute and it’s just actually like a great escape. So I feel pretty good about it and I feel very fortunate to be to be remote in that regard.

So I’ve got another question related to that, and it relates back to me right when Covid kicked off and we were forced to work at home, it was such a beautiful time because I was forced to spend that time and be present with kids, with my wife. And even till today, I will say for me personally, it was a bit of a blessing because I connected with with my kids and my wife in a way that I wouldn’t have done. I definitely wouldn’t have done during that time, right? Yeah. But then that became the norm. So we went back to work and perhaps started working from home and we became a remote company, right? And then what happened is the divide between work Prav husband, Prav and Dad Prav almost amalgamated into one. So this was very difficult for me to mentally shift between being work Prav and Dad Prav with within like 10s right? And then husband Prav and then walk into this home office where I’m sat now and then become the work guy, right? Mentally, I struggled with that to a point where in January I just had to get myself an office only 15 minutes from home. Right? But to make that mental shift of I’m going to work and then then the guy who’s going to walk through the door at the end of the workday is your husband and your dad. And and that that for me personally, I needed to make that shift because I felt like I was blurring the line between that and I wasn’t being challenged. Wasn’t being present. Do you do you feel that you just mentioned you go and like steal like ten minutes of joy here.

And provide office.

Space options for all of our employees for that reason? So if they want to go work out of the office, we provide them the ability to do that. For me, having worked in an office for so many years and doing the commuting in LA, I happen I’m fortunate enough to have a guest house that’s set far away from the main house that nobody ever goes to. So I.

Feel very.

Very quiet and I’m uninterrupted. For me, it’s more so about state of mind like, yeah, it’s not about the amount of time. It’s really about being in a good frame of mind, being present. And that’s where it can be challenging when you’re preoccupied with with other things.

What’s the competitive environment like? There must be there must be competitors. Who are they?

There are two competitors with FDA clearance in the United States. They don’t have clearances globally. So, you know, we’re competing on one way domestically and in a different manner globally. Certain other countries like basically have very like if you look at Australia and there’s not much not much else out there other than Pearl. And if you look at the UK, it’s more so regional sort of efforts often coming out of university with some subset of capabilities. Nobody’s really brought the kind of capital and firepower that we’ve brought to bear on this challenge. But you know, there are, you know, an array of competitors out there and, you know, there also an array of countries that have different sort of areas of focus. So I do think that there’ll be some confluence of companies that do certain things well that will help push those capabilities into the market. It won’t just be Pearl, you know, that’s not what we want. But I would say that it would be really hard for any new entity to enter the market now relative to where it’s at. It would just take years by default and a lot of money. So even if you’re a very large company, very committed to this, you probably have to buy something and and approach it that way versus build.

When you say people focusing on different parts of the market, do you mean some people focussed on dentists, some people focussed on DSOs? What?

Well, more so. Like some people might focus on applications for payers, right? For insurance companies, or they might focus specifically on C.F. or CT and not so much on 2D, or you have companies like Dental monitoring who’s really ortho focussed and not really focussed on radiographic anything, but more so on their own forms of AI and stuff like that. I mean there’s a lot of or you know, you have smile design which, which is employing AI to great effect. You have all types of laboratory applications that are, you know, applying AI for, you know, designing. Aspirations and stuff like that. There’s lots of stuff.

So before we looked at some of your darkest kind of days, when you look back on your career, what are the sort of the highlight days? What comes to mind when I say that? The high points. Was it like selling these companies or.

The high points for me are always pretty much the same. I remember the day where I realised that gum Gum had a thing that the market wanted enough that I could repeatedly provide to them, and I was like, okay, now we can just do this. And there’ll be a lot of challenges and growing pains, but now we know what to do. You’re not kind of meandering in the forest trying to figure it all out, right? And I would say that that’s a common experience across my companies and that I typically tend to do things that were historically never done before and unproven, and it was unclear if they were possible. We had a similar moment, I would say, at Pearl not even that long ago, where I was like, okay, this feels is like a more comfortable place to be because we know what we’re doing and we know that the market wants it. We know it’s good enough, all of that. So for me as an entrepreneur, that’s always the best moment because it’s like a real release that is often pent up for years. But you know, a lot of highlights along the way. Of course.

You said before.

When you’re looking at when you’re looking at all or nothing with the regulatory and you’re thinking about the investors money and that weighs on you, does it weigh on you when you have 700 employees or do you not? Are you not wired that way? You know, like are you thinking. Are you thinking that, you know, all of these people’s lives are dependent on whether we make it or not? Is that not in your thinking?

Is the question Is the fact that we’ve taken on a lot of capital and how will this responsibility kind of weighing on me all the time or not?

Is that capital?

Yeah, but but also the number of people, people that you have.

Yeah, it’s a lot of responsibility. And not only that, but it’s really like it’s responsibility to people who are giving like the entirety of themselves to the effort. So like, you really don’t want to let them down because they’re giving you so much, right? And you feel a lot more responsibility because of that. This is not your typical 9 to 5 work. This is like we’re all figuring it out together. We’re pulling weekends or pulling nights. And and yeah, I mean, like I said before, I think you have to get pretty good at sort of managing that level of responsibility and also separating it out and on some level realising that like you’re doing everything you can, you’re doing the best job you can do, and sometimes you just need to like let that be enough rather than drive yourself insane. But yeah, it’s all it’s all a big deal.

But you must have had moments where you’ve had some employee who’s really, really pulled weekends for you, laid their lives down for you, and then some. For some reason you have to let that person go.

Yeah, many times.

And that’s how do you deal with I think that’s like the hardest thing in all of business, right? Because it’s mean. It’s even hard to let people go who are terrible. But when someone’s been really good and really tried their best for you and laid their lives on the line for you to let that person go.

It’s the hardest thing to do. I feel that I have done that many times.

Many times.

Yeah. I mean, over, you know, a thousand plus employees and you have a lot of people that are very dedicated and their heart’s in the right place, but they’re just the wrong fit for your organisation for any number of reasons. Either they’re a skill set thing or it’s a talent thing or it’s a culture thing, right? And the best thing that you can do, in my opinion, is be honest, be kind, be generous with those people and try to be helpful to them. But you have to protect the enterprise as a whole. And you have to make, in my opinion, very swift decisions as it relates to the to the personnel at the organisation and this is why I don’t like the family analogy for companies, because you can’t fire your family. You know, I’ve tried but.

But you know, a.

Professional sports team, which is a good analogy that you know Reed Hastings uses a Netflix I’m kind of stealing that, but I think it’s the perfect one because we’re recruiting top athletes and we’re expecting a lot from them and they get released if they’re not contributing in the way that we need them to. And that’s a much better analogy. That’s much more accurate, I think.

And who who’s inspired you in business or who are who are the people you look up to in business?

Um.

You know, I find myself thinking, well, there’s a lot of people that I sort of more current that I know personally that I look up to a lot. But I find myself very cliche, I’m sure thinking of Steve Jobs a lot. I mean, what a phenomenal visionary. I know that he was very hard on people and could be, you know, a real. Hole and all that. But I think his level of of vision and commitment, like I understand where he’s coming from when he’s flying off the handle because he cares so deeply. Now, that might be the wrong human oriented approach, but I kind of understand and I’m sympathetic to like what he’s going through internally because he just wants to bring this thing to the world in a very, um, in an elevated manner. So, you know, I think there’s, there’s obviously many, but that’s one amazing.

I think we get to the final questions now.

Right Let’s get to the final questions.

Um, so we usually close off with, with the same final questions or fear and so, so my question is this a fear you’ve, you’ve conquered everything that you can in dentistry and I and and the business is financially done everything and you’ve achieved everything in life and you come to that point where it’s your last day on the planet and and your, your your little one is, is next to you and you’re surrounded by your loved ones and you have to leave three pieces of wisdom. What would they be?

First of all, how dare you for asking this hard question. I was telling you, Payman. I hope they had it sooner, but I’ll do my best.

Okay.

So I guess three pieces of advice. One would be. One for humanity generally, which I think would be well served to remember, which is it’s extremely miraculous that we’re alive and exist at all today. Like floating on this rock. And an infinite number of weird circumstances have led to the fact that life is possible at all. But the fact that we’re also living at a time of general peace and prosperity is just insanely fortunate and unlikely. And I think that to be driven by gratitude and love and light of that reality day to day is is well founded. And an important thing to keep in mind because we get very myopically focussed on, you know, the next thing or making more money or, you know, achieving and all this material stuff. But just the fact that we’re here at all is a real gift.

So do practice gratitude like in a in an organised way. Do you do it every day or something?

Oh, man. You know, one of the sacrifices that you make when you build a company like Pearl, because I got to that point at Gumgum, I had all this like time in a way that I got back to do the things that I wanted to do. That’s the nice thing about having a larger company is you can kind of focus where you want to focus. You have an amazing team elsewhere and you can get back to being a human being with a life and in particular interests. And you get into yoga and meditation and just like self-healing, you know, and all this stuff. And the truth is, all that goes out the window largely when you start a new enterprise because it’s gruelling and you’re just like, it’s painful, right? And there’s a lot of suffering. So I think that that’s the real cost that people just keep in mind if they want to start a business, that’s the sacrifice that you end up making. That is a very significant one, and nobody is really spared from that. I don’t think you could be somewhat better or worse in managing it, but you’re not really getting out of it. And you know, when you care a lot about something, I don’t think people mind working hard. But if you’re like, you work really hard and the thing is not realised, there’s just a certain type of pain associated with that that I think is challenging uniquely. So I guess the second one, I don’t know. I mean, I guess I’m getting back to it on some level, but I’ve probably been kind of bad at actively doing that. I’m playing more tennis. You know, I have a wood shop, so I do a lot of woodworking. I could always tell about my like the state of my mental health is a function of how often I’m in the wood shop.

That’s always a good time.

So you know a lot more now than it was, you know, a year and a half ago, say And another piece of advice, I guess, would be to find things to be genuinely interested in and vigorously pursue them. I think that I know a lot of smart, interesting people that are just not interested. And I think that’s a real struggle. And I feel for those people because I think there’s something they don’t want that it’s just that they can’t quite find it. But to the extent that you can, then I think that’s an important part of life. And then also just to be courageous in your decisions, because I think that fortune favours folks who are courageous and there’s obviously inherent risk in that. And you want to be smart alongside being courageous. But my guess is on a deathbed, a lot of regret will come as a function of not having been courageous.

Very true. Very true.

And and so how would you like to be remembered or fear was and finish the sentence.

Um.

My wife always says, you know. You’re not necessarily like super nice, but you’re very. But you’re. But you’re super good.

Um, and I think that’s accurate.

I’m not the I’m not mean at all, but I’m just very blunt. Um, and, but I’m, but I do feel like I’m good. Like, I want the right good things for, for my people and humanity. So maybe that.

The.

Blunt, good guy.

Yeah, the blunt.

Good guy.

Exactly.

Very cool. And then. Hey, do you want to finish with yours?

Yeah. We’ve got a fantasy dinner party.

Yeah, right. This is a tough one, too, because giving the hard question. So three.

People you want to spend.

Time with, dead or alive.

And I assume that these people could come if they come from different eras, the same language and conversation and all of that.

Yeah. Yeah. I mean, my.

Mind immediately, just a science nerd in me goes to like Alan Turing and Lady Lovelace and Richard Feynman and Isaac Newton and people like that. But. I guess.

It depends on what you’re optimising for.

So that’s a certain kind of optimisation.

If you’re optimising.

For something that’s historically interesting, maybe like Jesus or Moses and like Julius Caesar and like, you know, like Washington or something like that. But I think if you’re optimising for just like something that is highly entertaining, maybe. Fran Lebowitz. Christopher Hitchens. Like Einstein, I imagine. I feel like he’s a very.

It would be fun.

Entertaining one.

It’s a question.

But an interesting one. Yeah.

It’s been a massive pleasure to have you on. It really has been great.

Thank you for your time.

And I’m feel pretty sure Perl is going to do very, very well. And I can see by the team in the UK are doing a great job. You know, they they’ve gotten that name out there and they’re they’re at all the right places. So it’s good. It’s good to see that too. Really, really massive. Pleasure to have you, buddy. Well done. Good job.

Thank you.

Thank you so much.

It was a real pleasure. It’s a unique podcast and appreciate the thoughtful questions.

Thanks a lot, 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. Solanki.

Thanks for listening, guys. If you got this far, you must have listened to the whole thing. And just a huge thank you both from me and pay for actually sticking through and listening to what we’ve 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.

On Monday, we woke up to the awful news that Dr. Uchenna Okoye had been taken away from us so suddenly. Uchenna was a close friend of mine, although I suspect there’s going to be literally thousands of us who feel that way about her. She had a unique humanity about her, a kind person who you’d instantly open up to. One of the most infectious personalities that I’ve ever come across. Her wonderful smile, her laser sharp intellect. I’d always looked forward to having dinner with Uchenna, knowing I’d be laughing all night and I’d be challenged all night as well. When I worked with her, she was such a professional, hardworking, willing to take on new challenges with with substance and style. She was a real trailblazer in so many ways. Her ability to connect with people, her patients, her staff at the brilliant London, smiling and with the whole nation with her regular TV appearances. Couple that with a strong sense of right and wrong and integrity in both her professional and her personal life. As I try to find some comfort from this tragedy, I find myself thinking that even though she was taken way, way too young, unlike so many of us, at least, she really lived. She loved. She laughed. She inspired so many. Her legacy will live on for years and years. She made a real difference to the world. Uchenna leaves a young daughter who she adored. Our thoughts are with her and with the whole family. She had a strong sense of faith, and I’ll know. I know they’ll trust in a bigger plan for her in heaven. As I read the comments and tributes to her on social media, one by Dr. Bediako really strikes me. You are larger than life. You made a mark on this world. Your legacy will live on and will change many lives for generations to come. Gone, but not forgotten. Uchenna, you’re the best. We miss you and we thank you. Dr. Uchenna Okay.

But make it very clear that this is what you’re signing up to. And sometimes people say, Do you actually want me to work here? And I’m like, Yeah, but if you’re going to go to Oxford and Cambridge, you know what you’re up against. You don’t have to come to Oxford and Cambridge. You can go somewhere else. But if you want to join us, it’s not easy. And I know that it’s not easy. So yeah, I don’t know if that made me an evil witch.

Yeah. Yeah, it does. Yeah.

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’s my great pleasure to welcome.

My long time friend, Uchenna Okoye on the podcast. Yu-chien has had a brilliant career in dentistry, one of the most high profile dentists.

In the country right now and for a long time now. Welcome to the show, Uchenna.

Thank you. It’s good to be here. It’s taking you a while. You finally pinned me down, haven’t you?

You’re a busy woman, that’s why. Let’s. Let’s, let’s, let’s just start with, you know, where did you grow up? When did you think you want to be a dentist? Why?

Well, I was born in Nigeria, so I’m the oldest of six. And I grew up there, came over to England when I was about seven. And all I remember is how cold it was. And it’s still cold. I hate the cold. Um, and yeah, I went to school here. I went back to Nigeria for a year when I was about 1011 and then came back to England after that. So yeah, I’ve been here for a long time.

And what brought you back and forth? Um.

We came because my mom is a pharmacist, so she came to do her masters and we were never meant to stay here. So then my dad was like, We were becoming too anglicised. He used to moan that my my brother started talking through his nose. So posh accent. So we went back to boarding school and I went back for a year, kind of went thinking. I grew up on all these Saint Trinian’s and Malory Towers and thought I was going to Swiss boarding school. And instead it was like in the middle of the jungle and snakes and all that kind of stuff, which now was a great experience. Then thought my father hated me. So I went for a year. And it was great though, because it helped keep me, you know, have a real love of Nigeria. So if somebody asks me where I’m from, even though I’ve lived most of my life in England, I’d say Nigeria. That’s kind of where it resonates. And then I got ill and came back just after a year and then never left, really.

What made you become a dentist?

Um, it was a toss up between dentistry and medicine. You know, traditional African family. You could be a lawyer, dentist, accountant, all that kind of stuff. So originally it was going to be medicine because my uncle was a doctor, and then I did a work experience in the hospital and realised that the doctors didn’t do and it was the nurses that did the caring, didn’t like the hospital environment, which I still don’t. And yeah, dentistry is just great and I love it. I love it because, you know, get to be my own boss. I get to be artistic and it’s just the best job. But at the time, you know, when I told my dad that I was going to be a dentist, he was very dismissive. He was like, You’re not, you know, in Nigeria we have great teeth. That’s not a proper job. It’s not a proper doctor kind of thing. But yeah, he was very proud in the end.

What does your dad do?

Oh, I had a wonderful childhood. He’s he’s. He’s passed, unfortunately, quite a while ago now. But he had an ice cream factory.

Oh, really?

Was in the ice cream factory. And it’d be like one scoop for me and one scoop for he was way ahead of his time. He was an amazing entrepreneur, and I wish he was alive now because there’s so many questions I’d ask him and I’d say sorry to him because, you know, as kids we’d be like, Why can’t you take a holiday? It’s your factory. You can just take time off, you know, like now I own my own business and I’m like, Now I understand.

And where did you study dentistry?

I went to Guy’s when it was Guy’s, so. Yeah, so the secondary primary school, secondary school went to Guy’s, which wasn’t the best experience. Think Guy’s was fabulous from the perspective of teaching and even now. Well, it used to be that I could tell the difference between the guy’s graduate, you know, the things that we were taught and how we were taught. But I honestly did not like being at uni. So yeah, it is what it is.

Why?

There was loads of racism, so I guess you might as well dive straight into that one. Didn’t know if I wanted to be there because obviously the parental thing, you know, my dad’s attitude towards dentistry impacted me quite a bit. So initially my first year was about changing to medicine because that’s what my parents felt was the, you know, the right thing to do. So but, you know, there weren’t many people that looked like me, guys. It was you know, I made friends and it was a great education, but. Uh, guys kind of was. I still remember it, the comments like, um, that, you know, like how you’d have demonstrators and stuff and they’d come and they’d look at my work and they’d be like, Oh, that’s a really good feeling, you chenna for you. So there was always that what I call subtle British, you know, racism type thing. Um, and a few of us had a rough time there, but, you know, it’s part of who we were because in Nigeria we have tribalism, so we have different tribes. So I’m kind of, you know, that happens. And my parents very much just be the best that you can be and nobody cares who you are kind of thing. So it’s just stiff upper lip. So I found the whole Black Lives Matter thing quite interesting. Yeah, Let’s.

Tackle, let’s tackle it because I mean, it was a whole different era as well back then. I mean, we’re kind of similar age, me and you. So I, I think we, I can relate to that idea that, you know, what was acceptable to say back then is different now. But, but, you know, being a Nigerian lady and we’ll get to the lady part as well being a Nigerian lady. Take us from experiences that you’ve had that you would class as race, racist, race related experiences, getting jobs. Has that been an issue, patients walking in and being shocked or whatever? I know people who wear hijabs sometimes say that. They say patient comes in and immediately you can tell and bring it right down to today. Are we saying today it’s all over and there isn’t so much racism and, you know, the whole Black Lives Matter and all that. But give us some give us give us some of your comments about race and in your sort of growth from being a teenager to.

I mean, I guess upbringing has a big role to play in one’s perception of of stuff. So, you know, because okay, like I still my first memory of school in England when I would have been about 7 or 8, you know, like I was really proud of my English because although Nigeria has loads of languages, English is actually our official first language. So we could speak English. And I was being asked to in primary school to, to read a story and the whole class bursting into laughter because of my thick Nigerian accent. So it’s kind of like, you know, from that beginning things or kids, you know, ask me about worms in my hair or, you know, or being called rubber lips, you know, Now patients want me to inject filler so that their lips look like I mean, I mean, I just find the whole thing quite bizarre. Um, so it’s kind of like always there. You’re aware of it, but for me, it’s just you just get on with it, you know? It’s not something that defines me or I spent a lot of time thinking about. And I think for me it was more difficult as well, because you’re a black woman in a, you know, in a very male chauvinistic white world, you know, or whatever. But so, so I get stuff of the woman bit where it’s, Oh, are you the nurse type stuff or, you know, or the letters addressed to Mr. Okoye and all that kind of stuff. The black thing I haven’t had, like a direct spit in your face. You’re black, you know, type experience. I have always known and was always told from day one, you’re black. So you have to work harder, you know? But then my family is and my mother especially is like classic African. Well, why are you second? Why are you not the one that was first? You know what’s so it’s just always been there. And so that’s like.

So what do you think about Black Lives Matter?

I found it really interesting on lots of different ways. Um, I mean, I’m glad that the conversation is being had and it’s long overdue. Um, I found it irritating that a lot of friends were looking to me to kind of almost absolve them or to tell them what they should do, or they’re like, you know, we’re sorry this happened to you and all this kind of stuff. Like, I’m just like, Why are you what what do you want me to say? Or what do you want me to do? Like, and they’re like, Oh, teach us. I’m like, It’s not up to me to teach you. You need to go and find out for yourself kind of thing. So that was. Surmised that on the one hand. I mean, I. You know, I’m glad that they wanted to know and all the rest of it. But it felt, again, that the burden was on me to make them feel better about themselves or to give them the information that they needed to know. I’m like, No, you need to. It’s your turn to live in my world. So that was one. But then the other thing that it did was it made me think about stuff that maybe you just ignore. You know? And I think that’s probably what I found the most uncomfortable, you know, to kind of just sit back and think, oh, all right, there was that time and whatever. But I really didn’t dwell on it. I think I’m glad it’s happened. And I’m one of those people that I’m like, Absolutely. That whole affirmative action thing. I know some people feel that it’s, you know, it’s a bad thing or whatever. It’s not about putting people that can’t do the thing in the in the post. It’s about giving them an opportunity. And as a woman, it’s exactly the same scenario. You know, whether it’s your black or a woman, it’s other people to kind of encourage you and and mentor you. And there’s not enough of that in dentistry.

You really think that we’ve talked about this a few times, me and you, I think in the past some some dinner somewhere. But you really think it’s a lot harder being a woman than a man?

Yeah. You know, it’s good that you’re where you are and I’m where I am because, of course it is. And to be slapping you about the face, of course.

But listen, is it harder being a black woman or a black man? I’d rather be a black woman.

Why?

Because I’m not going to get the cops stopping me and thinking I’m a criminal every five minutes.

That is true. That is true. I definitely agree with you that. But then there comes another baggage you have to carry.

Where I’m making an example, an example of where it is advantageous to be a woman over being a man. I’m not I’m not I’m not pivoting my whole argument on that. What I’m saying is there are advantages to being a man, advantages to being a woman. When you say it’s harder to be a woman than a man. Let’s go to dentistry. Let’s go to dentistry. Go on.

Tell me why it’s harder to be a woman. I think, by the.

Way, by the way, by the way, outside of child care. Yeah, because that’s obvious. Yeah.

No, that’s. You can’t say out. You can’t just take the child care thing out. That’s.

Oh, oh, okay. Okay.

That’s a huge thing because the guys should be involved in the child care as well. Nobody asks that dude. Oh, who’s looking after the kids here whilst you’re in your work and all that nonsense?

My point my point is, if we just crop children out of the equation. Yeah, yeah, children out of the equation. Because obviously you have to take to have a child, you have to have maternity, you have to look after kids. And kids tend to, you know, a lot of them tend to to, to look to their mother and all of that. But I’m saying just let’s just say let’s leave childcare out of it in terms of career progression, just as a man, dentist, as a woman, dentist, where are the problems?

Number one, you can’t leave children out of it. So sorry, can’t agree there at all.

But let’s say before you have children, like, you know, if you’re 25 year old who’s never had children, you’re a guy or a girl. There’s no there’s no children.

So they still because I think as a woman, you generally think a lot of the things that women are really good at is not what’s the word? Don’t think.

Confrontational stuff.

Yeah, like like women we’re into we’re nurturers. We we’re team builders. You know, if I’m if I’m in a room and we’re discussing a problem, my natural thing is to ask everybody and get everybody involved and all that kind of stuff. And that’s not something that is, um, I don’t know if encouraged is the right word or admired or whatever. It’s the bloke that doesn’t know what the hell he’s talking about, but opens his mouth first and shouts out whatever is then perceived to be like, Oh yeah, he’s, you know, he’s, um. He’s got something to say and he’s, he’s making a contribution. Whereas women, we tend to sit back and we tend to be much more inclusive and want to try and involve people. So think that can create a problem and think like in dentistry. So how can you have a profession where the majority of, you know, even if you start even at my time in dentistry, it’s 50% women, you know, now it’s probably more women are the key elements that’s going to keep things going. But you don’t see women up there on the podium like you’re one of the few people that you know. Like when I kind of did a couple of things with you and it tends to be more, you know, you tend to have a few women smattered in there, but a lot of times the women aren’t there, but don’t think it’s necessarily because it’s just like not being aware. It’s like the Black Lives Matter thing, you know? It’s just not even.

Listen, I’ve been it’s been levelled at me. I think Bertie was the one who said it to me. We had a conference, The minimalist. I spoke, Prav spoke, and there was nine speakers and there was only one woman amongst them. And I hadn’t really thought about it, you know, I wasn’t really thinking about that question. And Bertie said to me, You should have had half and half. And I thought I found it a bit difficult, you know, because I wanted to make the best conference I could make. And I was thinking, Oh, I want someone from orthodontics. And it was minimally invasive. Someone from orthodontics, someone from Crown and Bridge, someone from whitening marketing person. I’m thinking, who are the best people I know for it rather than, you know, trying to find a woman. So there’s that. But but the other thing is that and I’ve discussed this before as well, is that if you really cared about women in dentistry, wouldn’t you look at nurses, hygienists, receptionists, they get a really rough deal in dentistry. Yeah, they’re the ones. Me Yeah. The fact that you all right. You’re not seeing dentists on the podium. That’s. That’s not the big issue about women in dentistry. The big issue about women in dentistry is that that group, the ones I said the Dcp’s are overwhelmingly women. Yeah. And their career prospects, what happens to them the way they talk down to by their bosses, all of that stuff? Yeah, that’s the real problem with women in dentistry.

No, don’t, don’t what you’re talking about, mate.

Really? Go on the hygienist forum. See what the way some hygienists are treated by their bosses.

Yeah, but. But that’s just think it has to start from the top because part of the thing of having more women like on the podium one is that from an inspiring perspective but to, to reflect the reality of the profession, you know, even within dentistry dental school. So I mean it’s a slightly off the cuff relevance this but had I had this fallout with quite a well known journalist, you know, from from a national magazine where we were talking about I was like flipping through the magazine one day, stick with me. There is relevance to this. And I was just like suddenly thought nobody in this magazine that looks like me, like like I get this magazine all the time and I love it and I love the articles and all the rest of it. I’m like and I just, like, flicked through the whole thing. Where am I? And they were like about to adverts or something that had somebody with colour. And so I knew her and it was like about midnight. I must have been quite grumpy or something. So I sent her an email, a message. I’m like, and she replied, And so we got into this altercation. I mean, we’re friends where she was like, I can’t believe you’re trying to say that I’m racist. You know? I’m like, I’m not saying that at all. I’m just saying I’m going through your magazine. I can’t see anybody that looks like me.

What was it, fashion magazine or something?

It was like a Sunday magazine type thing, you know, like style, style or whatever. Yeah. And so she was so affronted that she went to all the trouble of getting all the magazines, sending me a PowerPoint of all the things that had pictures or articles of people of black people. And so I smiled. I’m like, Yeah, there’s Beyonce here, there’s Will Smith, there’s whatever. I’m like, That’s so great. But I’m talking about people like me. I’m talking about doctors, dentists. And then that particular week it was interesting that there was a feature about lipsticks and they put lipsticks on. It was like a whole page of different lips, and there was not a single black brown lip there. Like there was just nothing. So I’m like, it’s about this. It’s about the fact that nobody has thought about this, that I’m not representing. I know that you’re all wonderful or whatever. You’re just going for that which you know, and that which you’re around. So you obviously don’t hang around with enough fabulous women that when you put on your lecture, they didn’t even occur to you. Or maybe if you’d hung around them more, you’d know it was more of an issue. And you like I do get it.

I’m not rejecting it outright. I do get it. I know.

You do. I know you’re right. That’s why I love you.

I do get it. But what I’m what I’m saying is, is that, you know, I couldn’t find the best people. That was that was my primary.

That’s a load of rubbish. No, no, no. Sorry.

No, no. Didn’t engage even the best men. Yeah.

No, you didn’t look hard enough.

I look. I look.

No, no. You just went to your buddies that you knew. Hey, can you, like, you know, the guys that you hang out with or the rest of the of, you know, And this happens so, so many times. And I will. No, I won’t. So.

No, go ahead.

Go ahead. Go for it. Go for it.

We’ll cut it out. Go on.

I will go there with, for example, you did ask me before about BPD and they’re doing job and all the rest and I’m not going to go into it. But that’s a classic one of what you’ve just said. So this group of great guys who I know, most of them like nobody, you know, that picture, that picture where there was all these men that they’d had their conference when the organisation first set up. And I’m just like, There is not one single woman and none of them saw that. Like, and then you ask like, what the hell happened? And it was like, Yeah, you know, we’re all buddies. We all hang out together. And some of us just thought, Hey guys. And we just happened to have this conference call and nobody there was thinking about it at all. So that’s why the conversation needs to be had, because if you have a you know, it’s scientifically proven that a, that an organisation that’s got that diversity is so much better, it’s so much more effective, it just functions better, you know, than just people that are all. Yeah. Anyway, so that’s all I’m going to say about that. But so that’s why and even when you’re talking about the thing about, um, you know, the dcp’s or hygienists or whatever, it’s again having the women there that will bring their problems to the front, to the first, so to speak. So I don’t know if it’s Facebook or what’s her name, the, the woman that’s, uh, Brains. Brains gone, huh?

The woman that what?

Oh, what’s her name?

The woman. The what? What does she do? I’ll tell. You know.

Isn’t it. Is she one? The CEO is the Facebook now. It’s not Arianna.

It’s the one that came from Google. Yeah.

Anyway, huh? Was talking about the fact of it wasn’t until she got she got pregnant because she suddenly realised that there was no parking, like she had to park for miles to waddle to wherever she needed to be. And so she was it was something that affected her. None of the guys had thought about it. None of them had had. It wasn’t there at all. And so that affected a change because she was there and she had Cheryl. Cheryl something about.

It. Sandberg.

Sheryl Sandberg, thank you. Yeah, she’s she’s one of the people that would love to sit and have a coffee with.

Definitely. Definitely. When did you start stop becoming just a regular, you know, general dentist and look to cosmetic dentistry because that’s definitely what you’re known for.

Yeah, I mean, I still consider myself a regular dentist. I’m a regular dentist. That just happens to be on TV. It’s not. It’s not. I didn’t go seeking to be doing what I’m doing. I think I got involved with cosmetics because, one, I’m a dental phobic, you know, I’m afraid if I had some really bad experiences and going to Aacd and I can’t remember how I got to Aacd the first time and it just totally blew my mind. It just opened me up to a whole world that I wasn’t even aware of. And that kind of started my my journey. And I started out with quite a lot of people. It’s like sometimes it’s a thing that dentists do that get really cross with people that behave as if they’ve always known what they know. Now, you know, they forget what it was like to know nothing. You know, like there was a time I didn’t know what a zenith was. And sometimes I’ll see some well known people putting other people down. I’m like, I was on the same course as you when you didn’t know any of this as well. So you need to be kind. You need to be kind to each other. And so yeah, that kind of started the journey and I’ve just loved it.

And I’ve always gone to America because I find it’s more forgiving. Um, more. I’m not a dentist. Dentist, as you probably you have told me many times before. And in fact, like I was saying to one of my team that if you had a year book guys, I’d probably be the person that people would say least likely to succeed. And um, they’re they are quite amazed, I’m told, apparently with my success which is, which is a bit irritating, but a part of me is like, no, no, no, no, no. But it is. I was always, you know, like I was a nerd at dental school. I was, you know, like I was like a mr. Bean kind of dental surgeon. Like if you’re disclosing somebody’s teeth, I would be the person that would drop the disclosing tablet on the patient’s white shirt. You know, that that that was me. So I have a lot of affinity and empathy for people that don’t know what they’re doing, that kind of that whole imposter syndrome thing. It’s always something that I always kind of struggle with. I’m told it keeps me humble, so that’s good.

It. Definitely humble, considering everything you’ve achieved, that’s for sure. But how did the thing happen?

Just busy minding my business, doing what I do, and they just approach me. It wasn’t because I was sleeping with a producer, as one very well known dentist told me.

Is that is that the kind of thing you mean about women? Yeah.

I mean, like, who would go and ask a guy that kind of ridiculous question, You know, like, um. So just they just came one day and they said, why are you.

I mean, did you have a PR working for you at the time? Why are you I mean, they could have gone to anyone.

No, I think there was stuff in in press about me. Okay. Um, so I started off, I had a I had like a part time PR person because I have her. Then I don’t think she was with me then.

You were very strong.

On your own PR, weren’t you? Because. Because we’re the practices are the very near sort of journalistic centres and you’ve always thought was always surprised me, is how strong you are at PR yourself without using professionals. I mean, it’s almost like you treat these people, isn’t it? That’s that’s the the rest of us have to get PR people to bring these journalists in. You mean you’re just their dentist? Yeah.

So it’s it’s the thing that I say to people, especially now in this whole Instagram era where don’t do the work for the picture or for the PR or for the article, do it because it’s the right thing to do. So when the reasons that I have a lot of journalists and people at my practice is because they might come, you know, like I had one Hannah who came for a whitening feature for I think it was The Telegraph, and she’d had whitening before, like about three years ago by another dentist who I knew. And she was like quite nervous. And she was like, it was so painful before. And I’m like, This woman had so much recession. Like it would have been like pouring acid in a wound. I don’t understand how anybody could, honestly. But but this person, the remit is do whitening one hour of my time or whatever and have articles. So instead I did buckle composites everywhere, sealed everything off. She was like, Oh my God. So this is what people that don’t suffer with sensitivity. This is how teeth are meant to feel. Then did the whitening. It was only the whitening that appeared on the article. But that’s okay. And I didn’t charge her for the bonding because it’s a PR thing. But that’s the right thing to do. You know.

Use the right whitening system for that.

You hadn’t come along then and that’s why they all stay, you know, and that’s why even though they might do an article, then they come back and, you know, and so like with the ten years younger, they just came, they came, they looked at they spoke to patients, they looked at pictures I’d done, they did a screen video thing, etcetera. And then they just turned around and said, would you like, you know, we really want you to do it? And I’m like, Yeah, sure. So is it going to be both of us? Yeah, Because at that time Surinder was also doing it and they were like, No, no, no, it’s just you. So I was a bit they came to me saying that they were going to change the format for it to be a magazine style. So I thought they were going to they were. And I know that they were talking to different dentists at the time.

For a while there you were the most famous dentists in the country. Definitely. When, you know, before it was kind of before the Internet properly took off. Right. How famous were you? Did you used to get recognised? I remember once we were having dinner and someone recognised you.

But wasn’t very.

Good famous person, whatever that means. I’m just even with the show, you know, it’s um, I could have done it smarter or if I was more millennial, but I would do the dentistry, you know, And so like, you know, there’d be somebody and I’m like, But she’s a stable hand. I know she’s having bright bleach. Shades isn’t going to work for her. She’s just going to stick out like a sore thumb, making sure that she can manage it afterwards. To me, the people is is key. So I was so busy doing all the dentistry. I mean, I think I’ve told you that story about the guy, you know, me coming out of the station. It was so funny. It was like on a Sunday morning and, you know, look rough, man. I’m like, real kind of like Sunday, rough stuff on. And he was like, Aren’t you? Aren’t you? He’s like, Aren’t you that dentist from the show from ten years ago? And he actually goes, You look rough, man. Can’t you afford a car? He’s like, Thought you’d be like, you’d be like a proper like you’d be in a BMW or something. It was so embarrassing. It was just. But for me, that meant that I even now, I don’t consider myself famous or I find the whole.

You get recognised quite a lot.

Not now because the show hasn’t been.

Yeah, but back then you used to.

But. I do get recognised because this, you know, it’s easy to recognise me as the black woman. There are not many kind of that. So I’ve learned to just smile at everybody. So yeah. But it’s, you know, I feel very blessed to, to be doing what I love doing. So yeah, but it’s not easy. You know.

The one thing about you, though, over the years gathered here is that you’re not interested in fitting in. So when you say you were the oddball, whatever, in dental school, just for the sake of the argument used to say to me, I’m never going to use website people that dentists use. You’d always look outside of dentistry, your practice. I remember when when I came there, everyone’s talking about guests. No one’s talking about patients. And and I remember you saying you recruit from outside dentistry and it’s kind of fashionable now. But you were talking about this 15 years ago. You used to say, you know, you used to recruit from hotels or wherever it was. Give me a little sort of first of all, why did you do that? Does it work well for you? But secondly, why are you that cat that’s trying to be different?

But don’t think I’m not trying to be different. You know, I’m not kind of purposely trying to be an outlier, as they say. I mean, like I kind of say to people, I’m incredibly shy, as I told you, and everybody just laughs. But actually, I really am. So to be one of the worst things anyone could ask me to do is walk into a room that people I don’t. I’ll just find the one person and stick to them like a leech. And so I but then I will notice people that are uncomfortable and I will force myself to overcome whatever to try and make them feel better, if that makes sense. Yeah. So I think that’s part of kind of what drives how I am in in practice and which is why most people assume I always find it so weird where people who have never met me just have these preconceived ideas, you know, have people that are friends now that they were like, Oh, we just heard or we assume that you have an attitude or that you’re really aloof and you, you know, you don’t hang out with. And I’m just like, But why? Why, why would you say that? But it is what it is. So I like the non Dental thing because because dentistry now is as you said, but before it never used to be about customer service, so had to go outside of dentistry in the UK. Yeah. To get that kind of you were.

Definitely one of the.

First service.

You were definitely one of the first that was looking at it directly from the customer perspective. You know, I certainly felt that when you everything about your practice, the the from the morning huddle to the decorations to the way he talks about your patients was was very much patient focussed, which is, as I say, very, very fashionable now. But but you were ahead of the game on that. Was that sort of partly to do with the phobia and you know, like some people get into dentistry and forget what it was like not to be a dentist and then there’s others and I can see, you know, people like Rona now charges another one that I’m very interested who completely want to take it the other way and just talk to the public and and sort of demystify. But you would definitely want the first who did that. Yeah. And you still do, I guess.

Yeah. I mean, for me, it’s I’m interested in people, so it’s always about the people and I’ll be the first one to be like, there are so many dentists with much better hands than me that I’m like, I can only aspire to do the kind of work that they do. You know me. I’m kind of like, you know, I don’t do good work and I invest a lot in courses. I know my limitations, but I’ve always been about the people. So it’s about making people feel good about themselves, making them be the best that they can be.

So in terms of just talk me through your patient journey, I’m a patient walking into your practice for the first time and just talk me through the entire experience from walking through your door to actually having a conversation consultation with you. What’s your consultation process?

Gosh, I’m still trying to redefine it in the Covid era. You know, I’m I’m actually struggling with it because I’m a hugger and a kisser. So let’s go.

Let’s go pre-COVID. What would happen.

Pre-covid would be schedule the appointment. And, you know, I’m guess I’m quite blessed that most people coming to see me know it’s, you know, it’s going to be an investment and they are looking for me or, you know, they’re asking for me. So they’d kind of come in. They come to reception. You know, we have a you know, by all the forms they’ve got, you know, what kind of lip balm they want and all that kind of stuff that I’ve learned from. So everywhere I go on holiday, I always hang out with the HR people, so, you know, Ritz Carlton and all the rest of it. And I pick little bits that will work. I’m always thinking about what will work when I come home. So we have that, the service menu, then the I’m always the one that comes and meets them, brings them in. We sit at a desk in my surgery. I don’t have a big posh space. You know, my my surgery is from Ikea, that kind of thing. I’m a proper Igbo girl. Um, so we sit on one side, talk about how can I help you? What’s going on? Just kind of that. That engagement.

What do you do to cater towards Phobics? Because you mentioned earlier on that obviously you you had a bad experience earlier on in your life and you were a phobic. Do you cater to their needs? Is there anything different that you do to sort of help people who are nervous about dentistry?

I think just just be interested. You know, all that old adage of nobody cares how much you know until they know how much you care. Is that just literally being interested? I’m so interested. Like, you know, I have friends that will be like, I’ve known this person for ten years and you found out in five minutes more about them than I have because I genuinely love to find out about people. So once with the trust, I mean, they love the fact that I’m a phobic, So that’s always a good thing. And so and I address that right from the onset, you know, you’re in. So I always say when when I finished talking, we go to the chair and I’m like, you know, I’m going to do this. You’re in control. If I’m wittering on, you want me to stop, you just let me know and all that kind of stuff. And then I’m just always, yeah, okay, let me know. You know, it’s just like it’s a two way. And so for most of the time, just that in itself is enough. I’ve never had I mean, I had one woman that it took us about six weeks to get her up the stairs. So like each appointment, she’d go up two steps. So she got to the top. It’s very rare. I’d say that maybe 2 or 3 people that we need to do sedation or anything like that. But for most patients, gisla appointments longer and just it’s just time. I mean, we’ve got the DVD glasses and iPhones and all that stuff for them to listen to music that that helps. So finish talking, sit them in the chair, do all the normal, you know, stuff that one would do, take pictures. Then we go back to the, you know, the side table, show them their pictures, talk about what I see, what they see, and then do a treatment plan.

There And then or do you do it at a different time?

The treatment plan. Yeah. No, I get them. What I always try and do is find something small to bring them back with. So if it’s that they’re coming back for the hygienist and maybe I’ll do one filling and then I’ll give them the treatment plan, then if it’s something really straight, you know, like if it’s, Hey, I know that this is going to be a smile or whatever, and I will, you know, give them the fee for maybe doing the articulated models or something, and then they’ll come back for that. And then I give them the plan.

What kind of touring plans are you doing? I mean, in terms of value? Are you sort of hitting the 20, 30 grand numbers?

Yeah.

And some people just completely shocked by that. You know, like what I mean by that is there’s a lot of people who don’t know. You could spend 30 grand on your teeth.

Yeah, I had somebody today, actually, and this is. And I was so angry. In fact, I was going to do a video about it where this woman had juvenile periodontitis. She’s been wearing a partial denture since she was 21. She’s head downcast, doesn’t smile, saw me on the show, wants to come and see what can be done. She’s lost her job. She’s an office worker. You know, She hasn’t got a lot of money. And I’m just like, But has nobody, you know, talked to you about implants? She was like, no, she has tried inquiring with her dentist, but he kind of said that it was really expensive and she shouldn’t bother, you know, And she’s just, you know, she’s divorced and she’s just hasn’t had a new relationship because she doesn’t want to have to address that thing. So then she’s like, how much is it going to be? What do you think? And I’m like, well, I mean, I use the analogy of a car, you know, if because she had no idea. And I said, you know, if I told you it’s going to be like a car. And she kind of looked at me in shock and I said, you should ask me what kind of car. We had to laugh about that. And then I said, you know, if it’s going to be 25, £30,000. And she was like, oh, my God, you know, I don’t have that. How can I? And then I said to her, Look, even the so-called celebs, nobody has money. I don’t have that money. Everybody uses finance, you know? And she was like, Oh, I can do finance, Really? And the conversation just changed. I mean, I guess that comes with confidence. But to me, I was angry on her behalf at this person that judged no.

One had ever told her anything.

Yeah, no one told her. So she’s going to go ahead and have treatment. I mean, I’ll be referring her. So it’s not that I’m keeping the money or anything like that, but I’m just like, Oh my God, you’ve been wearing a denture since you were 21. And and I guess that’s part of the thing of the passion. And I’m like, If you were my sister, you have, you have outside, you have to have implants. You can’t I’m not going to make you a new denture. You have to like and she’s going to do that because that’s just the best thing for her, really. It make such a difference to her life.

You’ve done a lot of the spear.

Yeah. Love Spear.

So tell us about that. I mean, if I’m a young dentist who wants to be like you, is it a good idea? How soon and how quick and how much?

I mean, all.

The speed courses, like the workshops are about $10,000 each. The thing that I was. Yeah, yeah. And the thing I will say because I still remember, because I started with Larry. Yeah. I’m part of the.

Larry Me too.

Biz I love.

Larry.

That’s where the car thing comes from.

Yes.

And so, you know, honestly, I remember paying for this not with my credit cards, not knowing if the card would work or not. You know, that kind of thing. So a lot of people and this is you know, and I have to say, this is this is me. I’m not saying this is what other people should do. You know, I admire people that sit there and they work on a plan and they save up. And that is like seriously the best thing to do. But I didn’t want to wait. Like I just had this thirst for knowledge. So I did all my things in America. You know, I didn’t want to be in England because he was there and it was a totally different experience. So I kind of did that. I did all of Pete Dawson’s stuff. I did the whole thing up to Masters and then Frank. Oh my God, He is just amazing, like. Teaching occlusion. So that, you know, literally is like, yeah, there’s just these dots here. And if you get the dots around here, then you occlusion sucks. I mean, no, I’m exaggerating, but it was really there. And Scottsdale is an amazing facility and every time I just love it. And it’s Gary Dewood and it’s just such a great.

Because I’ve I don’t know anything about it. I mean, I’ve spoken to people who do it, but I’ve never been there. I’ve seen pictures. Yeah, but how do they keep keep people coming back and spending another ten grand? I mean, like, is it the quality of the teaching is like, so amazing that the penny drops and you’re like, I have. I need more.

Yeah, absolutely. Because even me, like, I’ve been doing spear for ten years, more than ten years, like, you know, maybe 12, 14 and it’s just like and I’m still spending ten K on new courses that are evolving. And it’s a combination. It’s, it’s a safe space to learn. It’s a great place to be away and to learn the quality of the education. I mean, course, I know that there are people like Schmidt that loves course and I’ve never actually heard him, but both Course and Spear used to work together and, you know, like lots of boys, you all go and fight with each other and and things happen. But it just means that there’s even more choice for for people. So I would say to somebody, you know, hone your craft, like do your dentistry at least two, three years before you start jumping into all these courses and all the stuff. Because you I remember actually, I think it was about a year or two years after dental school. I did the Mike Wise course.

Oh, well done.

The year. Well, it was a waste of time and money. Didn’t know what the hell. I didn’t know what they were talking about.

Like another planet. Yeah.

It was. It was just like and was the course at the same time as core, I think. And it was like way I mean, it was good because it started me on that journey, but I’m like, I’d have gotten more out of it if I’d waited a little, you know, done a couple of years of things failing.

And so how much how much of your work is the simple sort of lime bleach bond type? How much of it is, you know, porcelain aesthetics and then how much of it is the sort of full mouth rehab sort of, you know, that that kind of work?

See, I so desperately want to do a lime bleach and bond. I was just like, it would be so much better for my back. Um, but, but I was saying to somebody that my niche is kind of like middle aged menopausal women like myself, so their mouths are complicated. So it’s all multidisciplinary, you know? So if I’m doing all my Invisalign is comprehensive, it’s, it’s part of implants. It’s part of whatever else.

Do you place.

Implants as.

Well? Oh, God, no.

I hate implants. Oh, Meccano. No, no, I said I said the implants out. Um, all right. Fillings. I do, Yeah. So various people each time I keep thinking I should get somebody in-house, but I quite like it being somebody else’s problem. So bread and butter dentistry for me generally tends to be part of bigger treatments, you know? So I’m still doing the fillings and all the rest of it, although at the moment I’m probably thinking of getting an associate so that I can have somebody a day or two a week so I can do because all the plans take so long to do.

How would you handle the fact that people want to see you and they don’t want to see your associates? I mean, how many practices are you on now?

A two.

With three at one.

Point. Right. Yeah.

But that one that. So the Harley Street one is kind of like the best day of my week. I just sit there and chat to people like it’s.

Just.

So you’ve got associates. I remember. Yeah. Jasmine used to work for you as well. Yeah.

Yeah.

How how did you get around that issue of people who want to be seen by you? Do they are you able to sort of deflect them into associates or is that not.

No, it’s fine. So I did a thing which I learned from I think it was Frank. I don’t know if it was Frank or Gary where. So all you guess initially. I see. First, because what I was finding was, you know, like maybe they were having routine treatment, then I might see them for something and then I’d be like, Oh, have you thought about having braces? And then it’s like, Oh, really? And then, you know, it’s that kind of thing. Whereas like, I guess have the confidence to do that. So it became a thing and I learned it from somebody. I didn’t think of it. So everybody walks in and I see them and then I’m like, okay, you’re going to go and see this person or you’re going to go and do that and it’s fine. And I think for me, it’s. They don’t know any better. It’s a matter of fact. It’s like, this is how we do it here. And they trust me. So they’re they’re okay with it as long as it’s in house. They don’t like going out, which sometimes can be a problem. They want to just stay in because then it means that, you know.

There’s the price. The same if you do a veneer and if one of your associates does a veneer, the price is the same.

Yeah, I don’t do the two tier thing. We’re the same.

Yeah.

I like that. So now you single mum.

Yeah.

Tell us that story.

Yeah.

That’s actually the hardest thing that I’m doing right now. And maybe if I was a mum earlier, I don’t know, it would have been okay. But I’m. I’m a late mum. Not by choice. It didn’t, you know, you kind of assume it’s going to work and it didn’t. But she’s also she’s the best thing ever. And, um, but it’s hard. It’s hard because you’re constantly juggling. You don’t. You just don’t switch off. You’re here. You’re there. You’re trying to. I still remember this is. This is funny. So we were filming. And it was like, you know, in the middle of filming. And so I have to have my phone with me because I don’t know what’s happening with her and something happened with the nanny. So I’m seeing the person. The camera’s there. The phone’s here. I’m texting, trying to find another babysitter. In the end, I had to, like, say, look, you know, you guys need to down tools and they had to bring her to the surgery. And then the babysitter came and took her home because we were running late. And it was just so that’s just the nature of of how things are. And it’s nice now because I think people are more forgiving. You know, so like one of my first ever mentors, Linda Greenwald, I know you’ve had Linda and she’s so inspiring and I still remember her kind of she opened her practice and, you know, like a few days after she’d given birth and the kids were there. And, you know, that’s like way ahead of her time. Like, that can happen now. But in those days, that just, you know.

Was.

She’s a superwoman, you know.

With.

Four kids and then and then everything else she does. But, you know, tell me about being a single mom. I mean, that it must be difficult, right? So you must rely heavily on nannies and the like.

It’s it’s hard. And some days you just think, what’s the point where, you know, So like, we just finished filming and for a week I didn’t see her. Wow. And I would leave, you know, like six in the morning and I’d get back and she’d be asleep. And so it was quite off putting finally, actually on the Saturday of that week when she comes in, because what I used to do was I’d leave a note and a present and she was really disappointed that I was there. Oh today mummy.

Um.

But it’s trying to be, you know, there’s, I think that’s one of the thing when you talk about women men type thing is, is it’s a feeling of guilt. Like I feel like I carry, I’m guilty of stuff all the time, you know, like patients are hounding me because I haven’t done their treatment plan or I’m supposed to do appraisals or something with team or, you know, the other day there was something I was supposed to put in her in her school bag, but I forgot about. So I’m like, I failed there or the school gate and she’s refusing to go to school. So now I’m like, they’re all judging me because I don’t drop her off enough here. And that’s why she’s clinging to me like a limpet and she won’t go. But the nice thing about doing it as a late mum is that there isn’t anything else I’d rather be doing, you know? Like, Yeah, kind of. It’s just she’s. She’s amazing. She’s. She’s, she’s my world. And because she was chosen. So I call her. She, she calls me. I’m her heart mummy because she was adopted. Yeah. That makes it all. Every time I want to moan to my two friends, they’re like, you know, you chose this, you wanted this, enjoy it.

So I’m trying to, but it’s. It’s the most rewarding thing. So. Yeah. Love it. Yeah. Love my life, love everything I’m doing. I mean, I think it’s hard. It’s so hard. Like, there’s some days that you’re just like, you know, what’s. What’s the point of this? There’s only one of me, but there isn’t anything that I would. I would drop. I just feel beyond beyond blessed. It is hard work and it’s constant. And and, you know, sometimes people say things like, you’re so lucky. Like there were days I remember the early days that I would literally I’m not kidding like sleep in the surgery, you know, it’d be like 2:00 in the morning and there’s no point going home. And I would have a shower here, give me my secrets now. And you just, like, wished I had a flat upstairs because you just so much work to do and all that kind of stuff. And you just get on. You just do what you have to do. But that’s, that’s kind of just I’ve always had that kind of work ethic. You you just have to do what you have to do.

What’s a typical day for you? You know, a day in the life? What time do you wake up? How does it all start?

Um, are you at work?

Yeah. Typical day. Normally wake up about five. So if I’m asleep at around 6:00, like, that’s a lie in and I feel behind. So I wake up. I’m a Christian, so I pray. I try and stretch because my back is having issues. And if. If I’m lucky, I can do all that. If I’m unlucky, a little person comes in like she’s an early bird, so she normally wakes up between 530 and 6 as well. So right at the moment we would spend about half an hour together. So she, she’d be reading or I’d be reading to her. She generally just wants to watch something, but don’t let her. And then I will leave the practice, leave home about seven, 7:15. Come to the practice. I’d like to have the first hour for myself. So to just catch up on stuff and determine what does.

The nanny come in at that point or does she live with you.

Know, she you know, Covid has made me more resilient because before that, I’m like, I don’t want anybody living with me and all the rest of it. And then I used to come in, but me and a four year old for all those months, I’m sorry, it was hell. I cannot lie. I’m like, it was just so hard. And because she was so little, she wouldn’t leave me alone. Like there was, you know, all these people having all these conference calls and all the things, you know, I didn’t get to do any of that at all. I just like, I was so jealous. So she she’s she lives with she’s in there with me. So that’s really helped. Yeah. Um, so I leave. I come here, we have a morning huddle. Um, normally the team would have sent me the night before, like we do what’s called a day list. So my nurses write, like, have a list of things, you know, the occupation, What happened the last time they came in, what they’re coming in for today. Any problems? So I read first beforehand and then we have a morning huddle and then the day starts and it just each day is kind of different sometimes.

What time do.

You get home again?

I try and get home by now. I try and get home by 630. So my job is to you know, it’s funny how I’ve changed. I used to be like, I have to get home in time to give her her bath, but that’s actually really boring and I’m tired. So now the nanny does the bath and I read the stories and put her to bed and then collapse.

What time do you go to bed?

Um, usually about midnight.

Wow.

Yeah.

Midnight to.

5 a.m..

Yeah, every day.

My dad’s growing up. I’ve always done that. My dad used to say sleep was practising death.

Yeah, I agree.

So you have eternity to sleep. So we’ve always, like, in my house growing up, no matter what time you went to bed, 6 a.m., morning prayers. Everybody’s dressed, seated around for breakfast kind of thing. So, um, friends didn’t like coming to my house.

One other question. I’ve always maintained your particularly strong on marketing and you always claim you’re not and all that, but. But you certainly, I mean, in the print age and the TV and print age, you dominated I mean, absolutely dominated. You really were maybe the highest profile dentist in the country. Now that we’re in the Internet age and the social media age and we can see all these youngsters kind of dominating because they’re you know, I mentioned Shady before. I don’t know if you’ve come across her. Um, she started her TikTok account in lockdown. Yeah. And lockdown now has 100,000 followers.

Oh, wow.

And TikTok is that kind of platform. It’s got it’s got massive reach. So what I’m saying, by the way, I don’t know anything about it myself, but my my question is, how how have you transitioned? Have you have you do you think marketing is less important than it was before? Have you transitioned? Um, you know, I myself had a chasm. Yeah. While Prav became, you know, one of the most important marketers in dentistry because he’d mastered Google. I myself had a problem when we went from print to digital. You know, I was very good at the two page spread ads in Dentistry magazine. And then when it came to digital, I don’t know what the hell to do.

Yeah.

Um. Think marketing. They’re coming for me. The police is vital, actually, especially in this day and age. I don’t think you can fight it. The world has changed. It’s just like, just embrace it. I mean, for me, I love Instagram, You know, it’s like this black hole that you can just, like, get. Sucked into. So you need to be careful and recognise that if I’m feeling insecure and bad about myself, you know, stay away from Instagram because it just makes you feel worse because everybody just.

The highlight reel, isn’t.

It the best? Yeah. And for me it’s interesting because, you know, like I treat all these journalists and people are sitting there and maybe like they’ve just finished sobbing in my chair. They’ve just had a Break-Up. They look rubbish. And then you just see, Hi. Yeah, it’s just like ten minutes later and I’m like, This is so fake. But as long as people kind of are aware of that. So, but the thing about the digital age is it’s allowed, you know, like there are people that I’ve met that could never have met, you know, whether they’re in Egypt or Syria or whatever the case may be. So it’s made the world a smaller place. I’ve had to how have I adapted? I think the thing I find challenging is just finding the time, you know, it’s kind of finding the time to do the things, to learn how to do it. I’ve dabbled in having other people do stuff, but it’s never the same. It’s not authentic. It needs to be my my voice. And I’ve kind of learnt like I like doing lives, you know, because people are there and it’s a bit like this, you’re just chatting to them and you don’t have to do all this hashtag type stuff.

It’s interesting because a lot of people are very uncomfortable in lives. I am myself, but I’ve noticed you. You’re living all the time. Yeah.

But I don’t know why you don’t like live because, like, looking at you, you know, you’re doing great.

But this is.

This is audio. Yeah. So if this was video, I’d be like.

Really? You begin.

To it. Um, yeah, don’t mind that, because I can. I guess that’s why I do the TV. Well, because I can switch off. I can forget that there’s a camera there because I’m so interested in the person that I’m. I’m engaging in. And also I now realise that I’m taking it much more seriously because it is actually starting to bring patience, which it didn’t before, not my kind of patience, number one. And then the thing is amazing. I mean, sometimes I think I give people too much free info because people are asking me questions and I’m like, You need to ask your dentist to do blah blah, blah. So somebody yesterday was like, Thank you so much. She started Invisalign, she’s up somewhere in Scotland and you encouraged me to do it and I just wanted to let you know it’s going well. So that’s I.

Think there’s a massive opportunity for someone like you in terms of the multi-platform story. So if someone’s seen you on TV, then DMS, you on the mobile, that that is a different level of engagement in terms of awareness engagement, then someone who’s only found you on the Internet, you know, and so there’s a there’s a massive opportunity. And then the other side to it is what you just said, that you’re clearly you’re comfortable talking to the camera, which I’d say 95% of people know, 99% of people. But no, I’m certainly I don’t pick up the mobile and start talking to it. I just don’t do that. Um, Prav does, right. But those two things, the fact that you’re comfortable talking to the camera and the fact that you’re on other media makes it just a really important thing for you to go all in on, I think.

I mean, I guess for me, the the USP has always been about education. You know, I don’t want people to feel about the dental experience the way that I do because I hate it. Like everything about dentistry is just awful. So it’s kind of to empower people, to give them knowledge, to be able to make their own informed decisions, you know, And it’s not, you know, because you’ll notice like on my insta, I don’t do I’m not a teeth posting dentist.

Like, why is that?

Because that’s not what I mean. I can’t say that’s not what I’m interested in or whatever. But my thing is I would hope that people would know that if they were going to come and see me, that the work would be okay. You know, that it would be good work. So I might be wrong. I don’t know. Maybe I should be posting more stuff. You should.

Because they work. Well, that’s the thing.

They want to that do work.

They work really well before and afters.

Yeah.

And also, I judged, you know, like, I’m like, nothing is good enough to post. There’s that aspect as well.

That perfection paralysis thing. That’s. That’s that’s the whole story of it. So. So you said you listen to this podcast, don’t you.

Tell me you do.

Oh, thanks.

I do.

It’s very it’s very good, actually. The other day I sent a DM to you, did one with Kunal and I loved his story about Prague. It’s just I was like, I didn’t know this about you. Oh, my God.

Yeah.

So Prav likes to end it on on his question.

So we’ve been wittering on without you.

I’ve been listening. I’ve been listening.

You know. You know, he’s been dieting. He’s. He’s not eating for 21 days. You know this.

No, really, he’s.

Yeah. I’ve not had a meal in nine days.

Why?

It’s just something I’m giving a go.

It’s what he does.

It’s a 21 day fasting challenge. So no food, just black coffee, water, electrolyte salts.

So coffee is meant to be part of it.

Black coffee is good.

Yeah.

He’s done a lot of research.

Yeah.

Good. How do you.

Feel?

I feel fantastic. I, um. About this time of day over the last couple of days, I start flagging, start feeling tired. But other than that, I’m feeling great. I’m productive at work. I’m still training in the gym.

Maybe I should try it.

After day three, it becomes really easy.

Really? Okay.

Hunger. Just the hunger just disappears. Really? Completely disappears.

He does. He has a lot of vitamins and things. I don’t know if that helps, but.

It.

Doesn’t help with the hunger thing, does it not? No, no, no, no, not at all. But it helps with the fact that, you know, I’m not going to be, you know, nutritionally challenged. Challenged. Yeah. Yeah. So make sure I get all my vitamins, minerals. The main thing is the salts. You don’t have the salts, you don’t have the magnesium, your neurones are not firing. You start cramping up all that. And that’s what I did the first time I did it. I really messed up, right? So now I’m drinking like 6 to 7l of water a day, 10 to 12 salt capsules. My vitamins are all packed in here, so I just rattle my way through them throughout the day and it just works.

Oh, can you send me details? I’d love to try it.

Absolutely. Yeah, no problem.

No problem.

And I’m actually at the end of this 21 day fast. I’m going to write a blog because I’ve had so many questions about the supplementation, about the process, the mindset and the reasons that I do it. Yeah. And the reasons that I do it are multifactorial, right? So on one of them is building mental resilience and mental toughness and the fact that if I can function and go without food for 21 days, then then it opens my mindset up to other challenges, right? And also when I get smaller challenges in life, then I should be able to handle them quite easily. So a part of it is about and then the other part of it is I’m probably a little bit crazy as well. And but, you know, on, on onto more important things, which is the final question. Imagine it’s your last day on the planet and your little one or not so little one at this time is is next to you and you’ve got to part giving three pieces of advice. What would they be?

Ooh. Yeah.

Three pieces of advice.

Um, I’d.

Say. Stay in your lane? Yeah, kind of. Just. Just. Just be. You know, it’s kind of like that thing of, like, just be you.

Focus on yourself.

Yeah, well, it’s not even to focus on yourself, but just be the best that you can be rather than trying to please anybody else. Or because you never. You never will. So just be true to yourself. Listen to your gut. Uh huh. Um, which I’ve not been very good at, but I’m getting better. Surround yourself with positive people. That’s so important. People that will lift you up, that will encourage you. Um, yeah. I don’t know. I guess the last. The last thing would probably be, you know, what’s a bit of my mantra, which is from the Bible, which is kind of like, you know, nothing is impossible with God. So if. If you just try it and even if you know that for me, there’s no such thing as failure, it’s just another opportunity to do the thing better. Of course. Yeah. Don’t know if that answers the question.

It does. It does. And just to just to finish that off, you know, how would you like to be remembered? You was.

You know, made a difference.

And then that’s the.

Thing I want on my tombstone, whether it’s the difference with the patients and you know that you’ve affected with the team. It’s funny being like, you know, really tough. I get teams that have left all the time sending me letters saying, Oh, now I understand what you were trying to get me to do ten years ago. Um, you know, or family friends kind of thing. But, you know, I lost my sister about five years ago. Unfortunately, she’s like my best friend, and it just came out of nowhere. And it really helped you realise that when all said and done, all you have is the memories of the things you did, the people you touched. Nothing else matters. It’s. It’s that so just. Yeah, that’s what I tell my daughter as well. Make good memories. Did you, did you did you question your belief at that point?

No.

Not at all. I mean, I was angry, you know, I was angry with God because I just didn’t you know, she she, I would say, was the heart of us. Like she was the best of us. And even now, I’m, you know, people say gets better with time and but it doesn’t you just like feel just thinking about her because she she helped run the practice for a while. So whenever I’m here, there’s always reminders of her. But you just get used to the whole being there all the time. So I just have to trust that, you know, God knows why. Um, when I get to heaven, I’ll kind of, you know, find out. But, um, yeah, it’s, you know, and I’ve never be like, oh, it was for the best or whatever because it was pants. It was horrible. And she was gone too soon and it was hard. But I still trust him and just like a parent, isn’t it? You know, that’s the whole premise of a relationship or my relationship with God in that in the same way as my daughter is like, we’ll get upset with me. Deep down, she knows I love her. She knows it’s for her best and she has that trust, whether she likes what I’m doing to her or not.

Yeah, that’s really well answered. Thank you so much for doing this.

On the phone for an hour and a half.

I knew you’d be good at this. Oh, it’s always enjoy talking to you. Maybe that’s the reason why Prav couldn’t get a word in. Um. Hopefully when times are a bit better, we can have a nice drink together. Or a dinner together. Yeah.

I miss your parties.

Yeah, exactly.

Yeah.

And it’s nice to see you. I think you guys are doing a really. This is my favourite podcast, I have to say, because.

Thank you.

Know, it’s true because it gives gives a different insight that very few do. In fact, I can’t think of any that’s not just about not Dental based. I think the thing that we as dentists need is to just try and kind of get to know each other a little bit better. Forget there’s enough teeth. I don’t understand the jealousy and all that nonsense. There’s enough teeth for everybody. It’s just like support one another and just, yeah, build each other up. So thank you. Keep on keeping on.

Cheers. Lovely to have you. Thanks a lot.

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 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.

Don’t forget our six star rating.

I think we’re far too quick to jump in offering solutions before we’ve listened to what the real problem is. So there are patients who are trying to get away from something, whether it’s pain or poor looking smile. And there are other people who are trying to go towards something. And the language that we use around that, the way that that’s presented. And I think one of the biggest pitfalls is to get sidetracked. There’s a lot of other problems in the mouth. But they came to you about the pain from the upper left central. You’ve got to deal with that first. They’re not going to pay attention to anything else you tell them till they’re out of pain. You’ve dealt with that presenting problem. And I think that we’ve had conditions in the past who are very, very good at certain things. They would start talking about the smile and the whitening and everything else, and the guy’s still sitting there for 30 minutes into the appointment in pain. So we have to figure out why that person is there and you have to get good at doing that quite quickly.

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 Dr. Nick Sisodia onto the podcast. It’s been a long time coming for me and Nick. We’ve been a few things got in the way. Covid and all of that. Nick is someone I think of as an experienced dentist, experienced in so many different ways, you know, accomplished clinician Implantologists one of the top implantologists in the country, runs a bunch of practices, a number of practices. I don’t know exactly what the number is right now, Nick, but we’ll get to that. But employs a lot of people and, you know, very sort of successful practices. He’s a teacher. This has been a past president of the BCD part of I.t. That I missed something out there, highly experienced in all of those different ways. It’s wonderful to have you, buddy.

Thank you. And I’m sorry it’s taken me so long to actually get around to sitting down with you to do this. I know you’ve been asking for a while. It’s a pleasure to be here.

You know, Nick, something I’ve always found with you is not only are you so accomplished at all this stuff on the other side of it, there’s a real human side to, you know, when we have an enlightened party and everyone is leaving and you’re like, What can I do to help? You’re sort of a hands on kind of guy in that situation. And what is it about you? You know, can you trace that back to childhood or what is it about you that’s good at organising stuff, wants to muck in and, you know, really do your best.

I’m not really 100% sure where that comes from, but it potentially is in the upbringing, as in my father is someone who’s over the course of his life, been involved with a variety of things, and you know, he’ll be the first one there. He may be the head of that organisation, but he’ll be there setting up the chairs and the tables and checking all the details. Be the last one clearing up in sort of mopping the floor afterwards. And I’ve always sort of followed in his footsteps, I suppose, in that way. So he set a good example, perhaps.

Where did you grow up?

So I’m I was listening to the podcast the other day and interestingly enough, I hadn’t realised, but George Pynadath George is local boy to me. I didn’t realise that until I listen to your podcast. I’m also from West London, so the Hounslow boy grew up childhood there, schooling there, played all my sport and other activities around that area till I went to university.

And you went to university in Bristol, right?

That’s right, yeah. Yeah. Bristol.

Same year as me, I think. Did you qualify in 95?

That’s right. Yeah. Both Martin I qualified same year in 95.

Same year as me. So tell me about your experience in Bristol. Did you and Martin, were you already plotting with Martin that you’re going to be opening a business together?

Not at all. Plotting would have revolved around social life and evening entertainment, perhaps at the weekend, I suspect back in those days. But no, we met very early on at university within the first day or two and became very good friends. But there was no plotting about business or any of those things. I don’t think we had a clue. My only objective was to get through the five years and qualify and to ensure that I had enough money to support the family and sort of keep people fed and watered. I didn’t have any ambitions about building businesses or anything. I had no idea about any of that back then.

So then do you remember a time when you decided you were going to be excelling at stuff instead of just getting through stuff? Because, you know, now now you’re, you know, so accomplished. But from the sounds of it, the way you’re characterising Dental school, you always want to get through dental school.

And yeah, so, I mean, dental school was an interesting time for me. I loved it, enjoyed my time there, but I didn’t find the first couple of years particularly easy. I was this needs to come out sort of not arrogant the way it might sound, but I breezed through school and that was a real problem. When I got to university, I didn’t really have to do anything. When you’re taught things and spoon fed things at school, GCSEs, A-levels were kind of a breeze. Got to university, not having done biology, A-level already on a little bit of a backwater.

The same was the same. What a nightmare. What a nightmare.

And then I didn’t know how to study Payman, So I kind of just, you know, was used to going to lectures or at school lessons, being told what to to learn. Didn’t have to do a lot of work afterwards. I just remember it and retain it. So that wasn’t intelligence or anything. It was just a great capacity to retain information and then regurgitate it. Got to university and there wasn’t any spoon feeding and I didn’t know how to sit down and study. I didn’t know how to revise, you know, all my friends would be revising and I’d be sort of twiddling my thumbs, figuring out what to do. So the first couple of years were tough. I did have a couple of retakes, I think, in the first and second year, but it did me good. I had to learn how to learn if. That makes sense. Yeah. And third year onwards, I’ve got my head down at the right times and had some good friends around me that helped me through that. So it was a fun time. I enjoyed it, but I also had to learn some new things that I wasn’t used to doing beforehand.

So, you know, like when when you think of a Dental career, it kind of you can for me, you’ve got that sort of university all the way up to, you know, first or second associate job that that period. And then and then you’ve got the next period and where it’s like sort of the ten year qualified associate might, might be, might be starting a practice. And then you’ve got your period now where you’ve been many years as a principal. What aspects of of you do you think have gone through the whole period? What kind of dentist have you been like because you’ve gotten yourself so involved in so many different things and excelling at things that, you know, sometimes the top implantologists doesn’t bother becoming the president of the OECD because he’s so into the surgery part. And yet you’ve got this broad sort of ideas, you know, broad sort of influence in so many different areas. What I’m trying to get to that what point was it where you thought, I’m going to excel, I’m going to excel at lots of things always that count mean no.

So I mean, I was very, very lucky with my first job. So I think we were the first year that had to do. You were probably the same qualified, same time was the same. So the first year that was was mandatory as it was known back then. And I was very lucky where I ended up. I had an amazingly generous principal trainer who gave me a real baptism. Baptism of Fire. I mean, the first day I turned up for work, having just been away for six, seven week holiday over that summer, turned up in August, and my first patient he’d booked in was for Molar RCTs all back to back on one patient and he said, Right off you go. And I never really looked back as And he was always there in the background, very patient. And I’d drill a bit and wait and blow some air and water drill a bit more. And about two hours later I might have probably just about got to the pulp horns, let alone the pulp chamber and the roof coming off. So. He took over the next tooth. He showed me how to get in there, how to access things. And he was always very generous like that with his time. And at the end of that year, I probably got an awful lot of experience. And I think one of the things at the moment I see is a lot of younger dentists aren’t keen and I understand the system is very different now to work on the NHS any longer, but I think we were quite lucky that that whole scheme through, through working on the NHS when the system was quite a lot different to the way it is now.

You could gain experience and learn. And my second job was also in a mixed practice in Hertfordshire. I couldn’t stay on in the practice because they had a new vet coming in. They only had three chairs and but they actually found me a job up in Hertfordshire. Just as generous to Co-principals and these guys would anything I didn’t know when I went to ask them help or advice on, they’d say, Don’t worry, book it in my diary and block your diary. And I would go in and the principal would do the appendectomy, show me how to do it. At the end of it all, he’d let me suture up. And then it also said, Yeah, just just charge that through. Nick Don’t worry. He would actually let me take the revenue for something that he’d just done where he’s teaching me. He was very, very generous like that. And I’ve always felt the same when we’ve opened our clinics and practices or at the BCD or currently at Bard. There are younger people that want to give back because people have generously given of their time and skill. To me.

That’s lovely, man. Do you think so? Do you think that was a bygone era when people used to do that? Do you think people still do that now? Do you still do that sort of thing now?

Well, certainly we do it in our clinic. I think there are a lot of good people out there, many of whom you and I know a lot of these people fly under the radar. They don’t really want recognition or anything. I think there are very many good people out there. It’ll be the exception where I think if you want to be a vet trainer or whatever that is currently called. I don’t see that you would do that for any real monetary gain. You’d be better off giving that chair to an experienced dentist if that’s what you were after or solely what you were after. So I think these people do want to train and develop and give back. And in private practice today, I don’t think you can run a successful private practice without having some culture of wanting to develop the team. I mean, the whole team nursing through two clinicians, through two therapists, whatever it is that you’ve got in your team.

And how long was it after that that you started? Ten Dental. How many jobs after how many years later?

So. Going back to what you asked me about excellence and wanting to sort of deliver that sort of dentistry, I think I probably worked two years in sort of NHS mixed practice, and I then went off to do a postgraduate MSC in Sheffield.

Oh, really?

And found very soon it wasn’t really delivering what I wanted. So I did about a year of a two year program and it was subject. So it’s period pros. People were very good. My consultants were great, but I really wasn’t learning what I thought I wanted to learn. I also came to the realisation that it wasn’t going to really allow me to do what I wanted to do afterwards. Very few clinicians are going to refer lots of complex work to Prosthodontists in the sort of volumes. I’m sure there are some established people out there, but by and large that’s the bread and butter for most GP’s. And given that it wasn’t learning what I wanted to learn at the time, I decided to leave that program. A very tough decision, but it was great. I left there, went travelling for a little bit with some friends, one of whom was a dentist, a friend of mine, and came back. Best decision I’ve made. I’ve met my wife very soon after that. Then at the time, wife to be so changed tack. But that year taught me that I did want to deliver dentistry at a higher level to do the very best I could. Whatever it was, whether I was doing a composite or a crown or a root filling, and I needed to carve out a way of being able to do that. So. Back then when you think.

That year, that year led to it, what dropping out led to it Because you thought, I’m not doing that. I’m going to go my own path and learn my own.

I thought I was going to get that as part of the MSC, learn to develop these clinical skills and it wasn’t happening. So I then dropped out and I thought, I’ve got to go and figure out where to get that education.

For myself.

For myself. So a bit of time off, as I said, went travelling, had some fun, saw a bit of the world, came back and then really got to work back in what was originally my practice. They were expanding their business had some more space for me, and I actually stuck around for about ten years almost in that clinic over a period of time. Best education you can ever get. So you’re learning new things on courses here and there. Got to deliver that dentistry in that practice. But I was there long enough to see the problems, the complications, the comebacks on my own patients. And I’m still in touch with the guys there at the practice. They’re still around, still both practising and on the odd occasion I’ll get a little WhatsApp saying, you know, Mrs. Smith is back and you won’t believe for that crown you did 25 years ago. Still going or and I’ll get a little x ray or a photo or whatever it is. It’s great.

So did you I mean, it sounds like there were brilliant clinicians and very good at teaching dentistry. But did you learn either directly or indirectly about practice management from these guys too? Because ten years is a long time to be in that practice.

Yeah, I think, you know, they were quite generous with that side of things as well. Nothing much was hidden. Not that I would ask any sensitive financial questions, but they grew that to three practices at one point and I would see what they were doing and we’d all, you know, of an evening once a week or so, enjoy a beer together and chat about things. And it was quite an open conversation. And I don’t even today really understand why people withhold so many things. You know, there’ll be things in your head Payman that you’ve learnt building Enlightened and these are business things that you’ve learnt, but by sharing them that doesn’t make someone else Payman Langroudi It doesn’t mean that they think the way that you think. So giving that information to somebody is not really going to enable them to go away and do what you’ve done.

Yeah, I think of that when people say, I’ve got a business idea and you say, So what is it? And then they’re like, Hush hush and don’t want to tell you as if you know, as if you’re going to take that business idea and do their business idea instead of the 11 that’s in your head. Yeah, exactly that.

And nine times out of ten, you know, the ideas that you and I have probably flop as well. I mean, you know, the number of things is ideas.

2% of the problem is it as we know, it’s the executions. It’s as if I say to you, Hey, Nick, I’m thinking of opening a bar in Soho. What do you think? Well, depends on the execution, isn’t it? It could be a massive success or a massive failure.

I think having been to having been to some of your enlightened parties, I think you’d be very, very good at that, sir.

So. Okay, what was was there was there a transformational, I don’t know. Course, in that period where you’re now looking for your own pathway, did you come across someone? Yes.

I think there was a watershed moment for me. So, I mean, I know some people love it and some people don’t particularly like it, but Paul Tipton’s year course, restorative year course for me. Was really kind of what I was looking for. And I get on very well with Paul that year going up and down to Manchester and back. Did change the way I worked and I learnt a lot about what I did want to do. Also certain things I didn’t particularly want to do. And I came back from that with a renewed sort of energy and enthusiasm for delivering comprehensive, holistic, sort of full mouth care. And that really helped me cement my thought processes around treatment, planning, understanding of certain things. And obviously from there things have springboarded so. You asked me why I got involved with certain things and. It wasn’t a deliberate plan. So I’ve never had this idea that I must. Get involved with organisations within dentistry and then go on to get involved with the executive committee or council or go on to lead them. I think that that’s just come as a by-product of things. I got involved initially, for instance with the BCD because there were a bunch of clinicians who were all striving to do the same thing as me, get very good at what they were doing, deliver excellent. At the time, aesthetic dentistry was the focus, but when we set the BCD up, it wasn’t just about, as, you know, aesthetics or cosmetic dentistry. It was about comprehensive clinical care. And I think there was a big misconception around that.

But that’s what we were striving to do a little bit naively, perhaps there was a lot of furore from certain corners about what are these guys trying to do? But that’s all we were trying to do. And the people that set that organisation up all in their own little way will have taught me so many different things. Some people about business, other people about clinical areas and we all still meet, you know, once in a while less frequently. So now, but we try to meet, if not the conference, but outside of that, as well as a smaller group and the same at Bard, I went to the 10th anniversary of Meeting of Bard, which is a British Academy of Aesthetic Dentistry, and that one meeting just blew my socks off. They had gone all out because it was their 10th anniversary meeting. Got speakers from all over the world who were at the top of their game. And I thought dentistry of a level that I hadn’t seen before in the UK and I hadn’t travelled much before overseas to see any dentistry. So I was seeing guys and girls showing stuff that I didn’t think was possible. Yeah, and I thought, I’ve got to get involved. I need to learn from these people. So I started travelling overseas because I wasn’t going to get that education in the UK and that involved clinical residency spending time with renowned clinicians for 2 or 3 days at a time, sometimes longer, and having the opportunity to ask them questions over a coffee or a beer afterwards as well.

How did you arrange that? Was that was that through your contacts at from the speakers? Or I mean, how does one arrange that?

A mix. So yeah, it would be occasionally I’d see a speaker, I think. Well, I want to go and learn more. I’d ask them if they’d organise a course, if they run a course and most of them do run courses and you can go off. Sometimes they would have said to me, Look, if you can get 8 or 9 people from the UK, we’ll run a an exclusive course just for you guys in English, because often it wasn’t their first language and I’ve done that. Certainly I’ve been across to Eric Van Buren’s in Antwerp. Eric’s recently retired but phenomenal soft tissue clinician and just actually really incredible pair of hands. I mean, he chose perio, soft tissue stuff, but all of his work was incredible and learnt loads from him, always kept in touch. But we had to take a group of, I think 10 or 11 there and we’ve done similar things in other parts of Europe as well.

Then. So when you finally did do ten Dental, was there not a conversation between you and Martin that said, Hey, one of us should be the implant guy and the other guy should do something else?

No, not really.

Not right, Because you both became implant guys. But, you know, that would have made kind of sense. No.

Yes and no. I mean, we don’t really tread on each other’s toes. There’s plenty of work in the practice. I mean, we get a lot of referrals for that sort of work. We don’t get the easy stuff anymore. The bread and butter stuff. But there’s plenty of work coming in and we from the outset wanted to share. So when we built the practice very, very quickly, we got our specialist colleagues in. Were going to deliver the endo or the perio or the other aspects that we didn’t particularly want to do. And at that time I was involved with implant dentistry. Martin was referring the surgery I was placing a little bit not huge volumes, but I knew I wanted to develop that side of my clinical skill set. I went my own way. But today Martin is far better qualified than I am. He’s got letters after his name and run, all sorts of things that I haven’t done. So I mean I’ve learnt by practising and he’s actually gone off and done it the proper way. Got a qualification?

Have you sort of subspecialized? I mean, do you do a different type of implantology to him?

No, not at all. We both cases come and there’s very little that he would send my way or my cases going his way unless we need a second opinion on something really tricky where it might usually in that scenario, it’s something that’s going wrong and we can’t figure out what’s going wrong. But otherwise, no, we both do the same work, not always the same route getting there. You know, we’ve got our preferences of how we practice. And in my hands, certain things work and vice versa. Martin will use something else to get the same outcome. But if you look at the pictures and the follow up long term, you’ll see that the clinical work is the outcome is the same.

So I guess, okay, so you’re splitting the implant work kind of 5050, but then what about the other roles? What are you responsible for and what’s he responsible for?

So it’s chopped and changed, but I think we both gravitate naturally to certain things when we first set the practice up. So the financial head was. Martin And he has a natural understanding of things to do with marketing, new technologies and social media and things. And I’m a bit of a Luddite when it comes to these things. So I normally sort of follow him along kicking and screaming in his wake on that front. But I tend to deal with the people side of things, the air side of things, and for the last few years sort of dealing with the business side of things and the background. So we’ve split that up, but we’ve chopped and changed over the years and swapped those roles as well.

Yeah, that happens, isn’t it? Over a period of time with partners that happens where you sort of you get comfortable in one position and then realise that, you know, maybe, maybe you should do each other’s job. It was certainly that’s happened with us as well.

But when we did that payment, it very quickly dawned on us that we need to kind of within 18 months or so we both realised we need to swap back to the roles. The reason we were doing the roles that we were is that that’s what we were good at. You know, we’re both good at different things within the business and that is why it worked so well.

Yeah. So. So you’re in charge of sort of operations then?

Yeah, you could say that. I mean, you know, it’s it’s not divided that it’s black and white that one mustn’t stray into the other’s territory. It doesn’t really work like that. Yeah. But yeah, by and large, you know. But we have regular chats. Every few days we’ll catch up whether it’s on the phone in person or these days via zoom often and whatever needs deciding on if it’s something that needs joint decisions. But we’ve been in the practice now almost 20 years, and I can’t think of that many occasions, if any at all, where I’ve done something that Martin sort of completely disagreed with or that he’s done something where he’s made a decision. I wasn’t around that. I disagree with that. That hasn’t happened. We think broadly think the same way.

Yeah. So, you know, what you said about sort of complementary skills. And certainly when I think of me and Sanj, we have very different what I’m good at and what he’s good at. And so things need to, I think in a partnership you need to find someone who does have opposite skills to you, but on the basic principles you need to be aligned.

Yeah, exactly. And that’s where we are aligned, I think.

Yeah. So okay, continue though. I mean, now we sort of fast forward to where is that group right now? How many practices are you, how many people are you? I can see the massive volume of just from the whitening, how much whitening you do to me, it makes me realise you do a lot of everything, like a lot of ortho, a lot of referral work outside of implants even so. So give me give me some of the headlines, some of the stats. Where are we? How many people you know?

So the team fluctuates a little bit here and there. I mean, like any business in London, we have an attrition rate and recruiting is quite a big challenge at the moment for all of us in dentistry and probably most sectors out there. It’s strange, but we are probably anywhere between 50 to 55 people got nearly to 60 odd at one point before Covid, but streamlined a little bit. We were three clinics until relatively recently and we’ve consolidated the third practice, which was our smallest site, and absorbed that within our practice not that long ago, very early part of this year. And that was a strategic decision because longer term, you know, before Covid, our plan was to grow and add more sites and then Covid put paid to that for a little while. We pulled our socks up within that sort of turmoil out. And at some point in the near future, the plan will be to probably grow that number of practices again.

Maybe explain it to me because. Because I don’t own any practices yet. But when do you when you look at buying another site, do you only do that when you feel like you’ve squeezed the lemon, squeezed the orange completely and the sites that you have? Because I think a bunch of people there’s almost a vanity metric in owning numbers of practices. And, you know, you can own four terrible practices or two amazing practices. I’d much rather have two amazing ones than four Terrible. And I know that’s not the strict choice, but when do you decide when do you decide to go for the next one? When you feel like you’ve you’ve got you’ve got, you know, the existing ones at full potential? Or is it when when a building comes up or. I know it’s a combination but what’s what’s been the driver.

So initially for us it was much more of an organic thing. We had a relatively small site in our original Clapham practice, which was three chairs and we tried to get upstairs, couldn’t get upstairs, tried to get next door, couldn’t get next door, thought about digging down in the basement, couldn’t really do that. And we don’t own the building. So we didn’t have the control that we needed perhaps to grow that site. So the decision was, well, the next best thing is to have another site, relatively local that we can manage. And that’s what happened. So we built our practice of both practices were built as greenfield squat sites.

Mhm.

Our third practice was an acquisition and that comes any business that’s acquired I think comes with this one little bit of baggage that you don’t realise till the first time you do it, which is a culture change within the business. It’s difficult to easily run through that business. You’ve got two sites that work very well for you, a third that you’ve acquired, but the culture within that business is different to your other two sites. And to inculcate that culture takes time. And it’s a lesson that we’ve learned. And I think for us, we would do that better Now. I don’t think we were particularly good at it at the time. We had to learn that it’s a skill, how to cascade certain things through the team, perhaps, You know, I tried to do it a little bit top down and that’s maybe not the way to do it. So some mistakes were made in that process for sure.

Expand on that. What do you mean top down? So you were dictating what has to happen and not getting buy in from the people.

Yeah, exactly. So you’ve got a team that’s working in a site and they’re going to continue to work there. We do things differently at the other sites and I’d sort of go in and say, Well, look, this is how we do it. Rather than asking why they did it their way and seeing what the benefits perhaps of adopting their processes might have been within our other sites, they will have had a rationale behind why they did it their way. And actually after a while I realised there were there were a lot of good things in the background that I wasn’t aware of. So it was more I should have listened for a bit longer before I started trying to make changes.

Well, yeah. I mean, look, dude, you’ve got two highly successful practices, right? And any successful endeavour goes down a few cul de sacs, right? There’s no way it’s by doing that, you get to it’s this wonderful word experience, right?

Yeah. So I think Martin told you our take on that Martin’s mother’s story behind that you might not remember, but I think she says something along and I’m paraphrasing experience is the best teacher, but the fees are too high.

Yeah, yeah, yeah. You can’t. I mean, it’s a funny thing. You can’t buy it. You can’t go on a course, can you? You can’t go on a course and get experience that doesn’t work. You can’t really accelerate it. I know what you said about those first two bosses. And and I get it, by the way, because I have some people sit in front of me here six years out and they just know so much more than I did when I was six years out. So you can accelerate it a little bit, but not a lot. Not a lot. And and it comes with a bunch of pain. You know, when you think you know, if you look at Nick, he’s an experienced implant ologist. What does that mean? That means stuff’s gone wrong. Wrong for him along the way. And he’s he’s got the battle scars or he’s an experienced, you know, practice owner. You’ve got you’ve got the battle scars.

But isn’t that what being a surgeon, a clinician, a dentist is all about is, you know, thinking things through to minimise potential complications. But we know we all know they happen daily. Whatever sort of dentistry you’re practising, whether it’s surgical or composite work or whatever, and you’ll make some mistakes and you’ll think, How could I do that better next time? And you learn from that and you move on and you’ll make a different mistake next time. And that’s the experience you’re talking about. Yeah, and it’s part of running a business or it’s part of being a dentist or a medic or a surgeon in any field.

Yeah. So. So with that in mind, then, when when when you think back on lessons that you’ve learned that, you know, perhaps a guy, you know, who doesn’t want to learn the same lessons in the same hard way as you’ve learned, what key things come to mind. I mean, for instance, let’s start with this. Those in that ten years, when you saw the failures coming in, what were some of the key failures that sort of made it made a mark on you and thought I’d better learn occlusion? So was occlusion you know the thing or what was it what were the key learnings in that ten years of seeing your own failures?

So I think it was probably much more to do with learning good isolation and bonding back then. I don’t think a lot of us were using Rubber Dam, you know, I didn’t get a lot of it because again, back then a lot of what we were doing was full coverage. So these were cemented rather than bonded restorations. But that transition was a big learning for me. You know, I thought arrogantly that a couple of cottonwool rolls in a, you know, saliva ejector would keep things isolated properly for me. And that wasn’t the case. So I had to learn how to use Rubber Dam properly. And I was reluctant initially. The other thing I mean, this is sound really, really basic, but. You know, we’re business partners, we’re friends, but there’s always a little bit of healthy competition, right? So I would look at Martin’s preps and his models and his dyes that would come back from the lab. And they’re always much tidier than me. And he’d laugh and he wouldn’t say anything. He’d laugh and wouldn’t say anything. And I’d be comparing his dyes with my dyes when they came back from the lab and the preps and the margins. And he kept quiet for a little while. And about six months he said, Nick, it isn’t that my hands are better than yours. He said, I wear loops and you don’t. And if something as basic as that, just wearing a pair of a set of loops and today wouldn’t work without my loops and actually probably without the light on the loops.

Yeah, I mean, that one’s changing, you know? I’d say still slowly, dude. Yeah, you’d be amazed on on our composite course here, more than half the class don’t have loops. And these are people who are paying, you know, £1,500 to come on a composite anterior composite course. It surprised me a little bit. Surprised me, too.

Usually it’s an attitude thing. I think so. I was at a social gathering last week, but there were quite a lot of dentists. There was the daughters, the daughter of that very first principal that I was telling you about actually got married last week. And one of the guests there was also an associate at the practice that I worked at back then before me. And he said something really interesting. He said, I’ve got these young dentists and they’re all reading their eyes. I said, What do you mean? He said, They’re ruining their eyes. They’re all wearing loops the day they come out of university and they’re all being conned by these loop companies. I didn’t have the energy to have this discussion with him, but I thought, no, this this is the problem. There’s a perception thing. You know, this chap is probably 60 years old and he’s probably not wearing loops himself, if that’s what he’s saying.

Absolutely. Absolutely. Did tell me about I mean, this is such an unfair question because, you know, I’m sure there’s a six year MSC on it. But tell me about Aha moments in Implantology.

So I think it happens in tranches of numbers of implants that you place. So my journey was I never actually set out to be an implant surgeon, by the way. So going to Sheffield was about doing Prosto, which is what I loved. And I started out found a surgeon. And I was going to refer to them. They would place the implants and I would restore them. But everything that came back wasn’t what I’d asked for. So I’d want, let’s say, an internal connection, and I’d want the implants put in a particular place. And the surgery was done very, very well, but it was kind of done to whatever he wanted to do. He’d got paid. He’d send it back to me and I know how to make it look like teeth. Yeah. And I thought, this is not working for me. So I had a different conversation with him. I said, Look, if I go off and do some course and things, will you mentor me to do this for myself? He said, Yeah, look, I’m busy enough. I’ll happily help you and guide you in things. So the reason for doing the surgery was to have the control. And it wasn’t to do with the fact that I actually wanted to be a surgeon.

And I would say that the first 5060 implants you restore, you’ll learn a whole bunch of things about the connection, about your system, about how to talk things in or glue them in, how to clean the glue, whatever it is that you’re learning. And you’ll follow those cases and you’ll pick up some things. Maybe you shouldn’t have done that. Maybe I should have done this. The next 50, you learn something else and the watershed sort of come in in big bunches of like follow up of your own cases. So you learn a new skill, you start doing it, but you’re not going to be very good at it at the outset. And you almost certainly need to evolve your technique from whatever you were taught, because in your hands it will work slightly differently. And. They pin things for me that have just allowed me. So I think you need to restore, let’s say, 100 implants, and that will make you a better surgeon. Okay. So if you want to do surgery, that’s great. But I would say you don’t do it because. Your surgical person, learn to restore first. You’ll see all the problems you might be facing and make you a better surgeon.

And I think I think I’m sorry to interrupt. I’ll let you continue the second, but I think when we qualified I don’t know about Bristol, but in Cardiff, Implantology was kind of a subsection of oral surgery. And then afterwards, maybe five, ten years after we qualified, it became clear that it had to be restoratively led. And it was, you know, that you you start with the end in mind kind of thing. Whereas whereas I remember at the beginning when I was qualifying and I was in university, the whole question was about this screw that’s going in the bone and the integration of the screw in the bone. It was all about osteo integration, just that was the most important thing. And then you almost do the restorative to that rather than the other way around, which is kind of where it went. So you’re kind of in a way you were in an advantageous situation. You came at it from the restorative side.

Yeah, we were quite lucky. So I think that division, I think existed in a lot of schools. So when I went to Sheffield, for instance, it was kind of 5050 in Brooke up there, Professor Brooke oral surgery side. And then there was Raj Patel in the restorative side. So I think but Raj came much later, so originally it would have been Ian Brooke I suspect so. It was a surgical thing at Cardiff. You’re saying it’s surgical at Bristol is very different. I remember there were two consultants particular Neil Meredith who you’ll know and Paul King if they had an implant patient, it was approved because there was a budget for all this and things. They would start running up and down the corridors, you know, doing a little jig and dancing because they’d found an implant patient. It was sort of those early days and but it was restorative. They were both restorative guys. So at Bristol, it was very much a restorative thing.

I see. So, okay. The Nuggets. The Nuggets. You say once you’ve put 100 implants in, what were those aha moment that you get from from from that sort of experience?

First of all, that these things are literally just, you know, screws in the bone. When I first.

Started out, it’s a great implant ologist. What makes it is it is it the soft tissue sort of integration? Like like making the soft tissues? Correct. Is that what it is?

Attention to detail. So I think you need enough hard tissue. But to make the case great, if that’s what you’re alluding to, I think you need. Abundant soft tissue and nine times out of ten, you don’t have it. You’re going to have to develop. That soft tissue. So these skills you only realise when you look at your own cases and they don’t look so pretty. They come back and they’re not so pretty. Or you see that there’s a little bit of a label defect as in a concavity around your upper central crown. It doesn’t just quite look like an actual tooth anymore. You start realising that, okay, there’s enough bone, the implants integrated, it’s healthy and you’re looking at it year after year and it looks great on an x ray, but. If you took a picture. It’s not one that you’re particularly proud of and that leads you to realise that, okay, I need to hone different skills here. This is a soft tissue thing and I need to build that tissue. Hence, for instance, talking about going to see Eric Van Doren, a lot of cases, posterior maxilla, you’re not going to have enough bone.

Even the anterior maxilla, you’re not going to have enough bone always. And you need to go and then learn how to regenerate and rebuild bone. And there’s a variety of different ways of doing that, and they all work. So you need to decide, okay, in my hands what’s going to work? You know, am I going to use urban sausage technique or am I going to do this with a curry technique and get good at that? Because ultimately it doesn’t matter which way you do it, it’s the outcome, right? Yeah. And sinus grafting for me was a big thing. You know, probably placed 100 implants before I forayed into that area. And I think in the UK at the time, the teaching wasn’t ever going to be hands on or practical. So I had to go overseas where people were teaching live surgery or there are some places doing cadaveric sort of teaching, but kind of cadavers don’t bleed. Yeah. And when you’re doing surgery and things are bleeding and you’ve hit a vessel, it’s a very different environment, right?

Yeah, for sure. And do you do. Where do you where do you stop? I mean, so do you do all on for. Do you do the implants and the zygoma. What are they called. Yeah.

So zygomatic pterygoids.

Mean, zygomatic. Do you do all that?

We place pterygoids We don’t place the zygomatic. We have a visiting surgeon that comes in and does the zygomatic for us. We don’t. Have that many cases a year. A handful. And I think if you’re going to get good at something. So both. Martin I’ve done courses to place and learn to do zygomaticus But we took the decision that unless the demand is there, where we’re going to be able to develop that skill properly, it’s probably not something that makes sense for us to do so. We know our limits. We’re not doing enough to get very good at that. We call a visiting surgeon into place the zygomatic fixtures and when they do that, they actually place all the implants in that arch. It’s not like they do the Dogmatics and the Martin take over for the rest. But everything else, yeah, we do ourselves. I do think there is a huge shift, perhaps in slightly the wrong direction with some of these implants as well though I think we forget that the sinus is something you can graft and regrow bone. Yes, it’s a slower route to getting there, but I don’t think this sort of surgery is for every surgeon. It’s certainly not necessarily for every patient as well. And they’re not without their problems and complications.

Yeah. So when I asked Andrew DeWitt that question, like, what’s the essence of being a great implantologists, he said something about spatial awareness. Yeah. You know, I wasn’t expecting him to say that it was.

Yeah. So I think what he’s alluding to there and maybe elaborated if you ask him a follow up question, but it’s about 3D thinking. So you mentioned occlusion earlier. Yeah, I. Haven’t ever really found occlusion as a concept. That’s that’s difficult. I just think of things and maybe I’ve always been like this. I see things in 3D. And that makes life a lot easier. But I think that can be learned if you’re not good at that at the outset. But that’s what I think he’s talking about. And I’ve seen some surgeons who not only think like that, but they’re ambidextrous. They can do things equally well with both hands. Some of these people are very, very highly gifted.

Mm. And what are the stats around implant patients now? Are there more implants going in than ever before? Have we caught up with the rest of Europe? Where are we with that? Uk wise.

I wouldn’t know the numbers in the UK, but I think certainly there are more and more places.

Behind.

For years we were you know, if you’d asked me 1012 years ago, I think for instance in Brazil we were about one tenth the number that they were placing in Brazil and lots of parts of Europe as well. And I think there’s two issues here. One is. Historical to do with the NHS and funding. You know, you could do a bridge, but you couldn’t do an implant and it’s taken a while for that perhaps to change, for people to start thinking, okay, well actually I need to offer everything both ethically and medico legally. So that I think took a little while for us to shake off. And then the numbers of surgeons available in the UK to actually place these things. I think we need more people placing, you know, we need general dentists with good hands placing. If there’s plenty of bone, there’s no real surgical risk. A competent dentist can place the implant, no problem at all. And we need more and more younger guys and girls doing that. And I think it’s only really when they reach their limits for perhaps whether it’s to do with lack of bone, soft tissue or, you know, sinus grafting, they then refer those complicated cases on. And that’s what Martin, I’ve always sought to do. So we’ve had a number of people over the years, they refer cases when they’re ready to do surgery, will help them. We’ll mentor them. We’ll guide them to do that. And people have said, well, surely you’re losing out. And the answer is no. All that happens is we get their complex cases and when they’ve learned those skills, we get their even more complicated cases.

Nice. Tell me about the organisational structure of the practices. Who are the reports? Is there a manager at each site?

So it’s a fairly flat structure. Martin Myself and we have an area manager which who covers both the practices. We have an operations manager in the office, and we have a finance person that looks after all of the ins and outs of money. And sometimes we’ll call me. Martin. Tell us off for spending too much on a on a new scanner or something like that that we fancied.

So have you on that side note, I went to Martin’s lecture at Bard and one of the most beautiful lectures I’ve seen in years, but very digital. If you have, you also taken on the whole digital side. Yeah.

So the whole practice now, you know, we’ve got multiple scanners, we’ve got CT scanners at both practices as well. Everything that we can do digitally, we do. And the only time that the comes out as if the scanner for some reason is having a bit of a moment, which does happen. Technology crashes sometimes. But otherwise pretty much everything. And that’s not just for Implantology but across the board. Restoratively is digital. Sometimes we’ve got two dentists waiting for we need more scanners. You know, I think that’s the way it’s going.

Yeah. And what about as far as associates? I mean, you’ve had when you look at the list of people who’ve gone through your practice, some of the sort of up and comers who then become, you know, in their own right, you know, teachers and so forth, what do you do? Do you actively try and search out young talent? How much of it is is, you know, what you can give them and how much of it is what they can give you. Tell me your sort of learnings, your nuggets around attracting and keeping these people.

So there’ll be two elements to that. I mean, there are obviously specific skills sometimes that we need within the team. So an oral surgeon, for instance, we’re going to go and find that person. They need to have a certain skill set already. And we tried and tested within that discipline because we’re taking referrals for those wisdom teeth or complicated extractions, whatever it is. Same goes for the endo or the perio, and we’ve got multiple orthodontic specialists as well. But from a general dentist perspective, we have a team that will have experienced people that like doing certain things. You know, the sort of people that you’re thinking of that have been in, gone perhaps on to other things, set up their own practices and we actively seek those people out as well. But equally we have younger dentists one or 2 or 3 years out. And if they’ve got the right attitude, what we want is that we will teach them and it’s a journey and at a certain point they realise, okay, I’m now doing this competently. What’s the next step? It’s building blocks. Go and learn about soft tissue, go and learn about X, Y, z, and they will all generally follow our advice. Go off and do a course, sometimes shadow us or internally shadow somebody else. And when they’re ready, if they want to go and fly solo, we’re happy to share that as well. 1 or 2 people that have gone on and set up their own practices will tell you if you have them on the show, they’ll tell you. We’ve shared freely and given advice. There’s enough room for all of us.

Yeah, I remember saying something like that.

Yeah. You know, he’s a good guy. Deserves the very best. He’s worked very, very hard. Talented guy. And, yeah, we’ve helped him along the way where he’s wanted help. He didn’t need much help. You. He knows what he’s doing.

Yeah. So, so then, you know, expand on that. When you say right attitude, of course, someone who’s curious wants to learn. Get all of that. But is there is there more to it than that? Is there sort of communication that you can’t teach?

So I think the soft skills are difficult for us to teach. I think they can be learned. I think they can be acquired. But yeah, you want to engage with people and see where their soft skill set lies because you could be the best clinician, but unless you can talk to a patient and unless they’re willing to come back and have that treatment with you and I know Prav did something recently, you know, the s word or selling. Yeah, we have to sell things to patients. We have to guide them to make the right decisions because you’re not going to deliver that dentistry otherwise. And that is something we’ve had talented clinicians sometimes who struggled with that but pointed them in the right direction. They go and learn some of those things, how to present a case, how to put that together and explain it to a patient in language that they can understand. Others have come and they’ve taught us, you know, they’re naturally good at it and we’ll pick up when we see clinicians who are converting really well. I want to my mind and Martin’s eyes light up in our ears prick up. We want to go and see what they’re doing because I’m sure we could learn from them.

Yeah, but so if you’ve got two candidates, one’s got the soft skills and one’s got nice before and after pictures, but not the soft skills. You’d always take the first one or not always, but you’d bet on the first one.

But it depends if, if the person who’s doing the beautiful dentistry is willing to go and learn that we think that they are open minded and can acquire those skills. Yeah, the soft skills, then I think that that’s okay. But yeah, I would favour the person with the soft skills because the dentistry can be taught to most of us I think far more readily.

It’s so interesting isn’t it, because I’m sure young dentists wouldn’t think that that’s the actual situation.

I think that there is a huge shift to a lot of younger colleagues trying to acquire very, very quickly certain clinical skill sets. And I would say that actually one of the things that we were very, very, very lucky at Bristol to have a master and I still talk about this once in a while. We had a whole module in our second or third year over two years. It was called Health and Society, and it was this wishy washy sort of bunch of things that you thought, What is that about? But at the time you’ll remember there was a whole furore back then with HIV and we didn’t know what was going on. We didn’t have the antiretrovirals back then and we were still treating these patients in sort of almost like Covid type situations at the end of a session. So the room could be fumigated and wiped and sprayed and, you know, all of those things. And we had a session where they actually had the Terrence Higgins Trust come along and a couple of HIV positive people come along and chat to us and tell us their perception of what life was actually like living with HIV and Aids. And there was a lot of other stuff about inequalities in health and social strata, and it was the best thing because actually that whole thing was about soft skills. And I don’t know of any other school that is doing that or was I don’t even know if they still do it at Bristol now, but we certainly had the benefit of that.

Nice. So when you think about your practices, you know, you started them from a squat, which is high risk in a way. And, you know, someone else is thinking about starting a practice. And if someone hasn’t been to your practices, I mean, from memory, visual, minimal chic sort of look that they’ve got about them, they’re in funky sort of locations, nice, nice high street locations in nice parts of London. And how much would you advise someone today that location and design, how important is that? And I don’t think it goes without saying, right. No one wants a beautiful practice where it doesn’t. You know, the density is not right, of course. But how important is location and design? Because you guys, you know, you’re a bit ahead of your time in that sense, right?

I think location is probably the biggest thing. Once you found the right site, then of course you’ve got to make it attractive to patients and don’t think that necessarily involves. Too many frivolities and fancy things. It can be quite simple but elegant, clean. What patients want versus what we perceive them to want is often quite different. I don’t think we often try to drill down in that, and there’s a lot of research out there in these things. If you care to look colour, science, sound, smells, all sorts of things. And perhaps we were ahead of our time, you know, we didn’t have anything that contained. For instance, Eugenol smell is one of our most basic senses and it can take you back. If you got somebody who’d been in Auschwitz and you had burning flesh anywhere near them, they would know what that was like and it would take them back to a memory they did not want. Right? And we’ve all been there with certain smells. So we made a this is the detail of things. We made a conscious decision. No Eugenol We don’t want that Dental smell. And the water would always be turned on super high when you were drilling teeth. We don’t want that burnt tooth smell. And on top of that, we had scent burners, diffusing oils in and around the practice. And the patients could actually we got even better. We’d have our selection. We’d ask the patient when they walked in, what scent would you like in the room? And someone would choose Lang Lang. Others would want Eucalyptus, whatever it was, but we’d make it about them.

And this was before. Before every third shop was an aromatherapy shop. This was a while ago.

Yeah, 20 odd years ago.

So, yeah.

We were trying to make it about the patient. So if you walk down the street, what do you see? If you walked in the practice, what is it you’re seeing when you walk into the treatment room? What is it you’re seeing? Sit in the chair. And I think every dentist should do this. By the way, every few months, sit in your own chair, recline it, and look at what’s on the ceiling. That cobweb, that spider crawling around, whatever it is, that little spatter of blood, because we don’t look up often enough.

Yeah, true. And, you know, your own sort of bedside chairside manner. I mean, I’m sure it’s not just pure marketing, but Martin Prav, it says it says you, you listen to the patient and that’s that’s a key thing for you. Did you sort of hone it? Were you always good at that? Is that is it the big experience word? Yeah. So the hints, hints around. I mean, it sounds simple, doesn’t it? Listen to your patient. But.

Now, I think we’re far too quick to jump in offering solutions before we’ve listened to what the real problem is. So there are patients who are trying to get away from something, whether it’s pain or poor looking smile. And there are other people who are trying to go towards something. And the language that we use around that, the way that that’s presented. And I think one of the biggest pitfalls is to get sidetracked. There’s a lot of other problems in the mouth. But they came to you about the pain from the upper left central. You’ve got to deal with that first. They’re not going to pay attention to anything else you tell them till they’re out of pain and you’ve dealt with that presenting problem. And I think that we’ve had conditions in the past who are very, very good at certain things. They would start talking about the smile in the whitening and everything else and the guy still sitting there for 30 minutes into the appointment in pain. So we have to figure out why that person is there and you have to get good at doing that quite quickly. And a lot of that is verbal. They’ll tell you. You then need to ask more open questions, of course. A lot of it is non-verbal and I think we’re all pretty good naturally, if we just take the time to pick up on those non-verbal cues. We’re wired that way. You can see in someone’s eyes if they’re happy, not happy. Suddenly they cross their arms. They’re closing off. We all have these skills. You just have to tune into it when you’re doing that initial consultation.

And do you do you provide training for the team on this aspect?

We try and make sure that that initial appointment, the new patient consultation, is as close as it can be. For every patient that walks in the door the same. Now it won’t be because payments got payments. Personality and nicks got nicks personality. And, you know, you might be a bit more jokey than me. I might be a little bit different in the way I actually do things or say things. But broadly, the journey needs to be the same. And when anybody starts with us the first week or two, they will shadow not only me and Martin, but other clinicians, so that that initial journey is standardised for everybody as best it can be.

So I want to get to darker times and we talk about this word experience. We talk about experience coming from pain and from mistakes and things going wrong. Tell me, tell me about what comes to mind when I talk about things going wrong. And I’d like both, you know, clinically from a business standpoint, even even with your sort of teaching and, you know, around the the societies and all that, what comes to mind when I when I say that in those different areas.

So the first thing that comes to mind clinically is. Learning to recognise the problem. Patient. Nine times out of ten. When I’ve had problems with patients complaining or threatening to go medico legal, which we all get nowadays. It’s the patient that I was even sceptical about taking on in the first place. So I think, you know, we can’t turn away all patients. But if there are alarm bells ringing at the very outset, there are plenty of other dentists out there who might be able to look after that person better than you. So the biggest stresses have come from people that actually from the outset probably thought, no, I shouldn’t treat this person. And I’ve got good at asking my nurse, you know, what do you think? Do you think we can treat this person? And sometimes the nurse will say, Yeah, it’s just they’re nervous or whatever. And I’ll think about whether I agree with the nurse or not as to whether to take them on clinically. Yeah, unfortunately, I’ve made all sorts of mistakes. You know, compressing nerves all resolved. Patient isn’t numb anymore. But these are things that you really do start losing a bit of sleep over and sometimes biting off more than you can chew, thinking that you can do something just because you went on a course on Friday and doing it on Monday.

And I think my biggest mistake on that front was a patient who very wealthy young guy, parents had died young. He inherited. That much money that was flying in and out from Europe by private jet to see me. Money was no object, but he was in charge. He was wired that way. He’s one of those guys. He would tell you what you were doing. So, Alpha, here’s what I was doing for him. Yeah, but I was now prepping 28 teeth and fitting 28 restorations two weeks later for him. That’s what I was doing for him. At his request, he told me, and against my better judgement, I took it on. I delivered it. It’s all fine. It’s never no problems, follow ups. Great. But I can tell you the amount of stress that caused me, the sleep I lost over that case. Wondering whether he’s going to come back with a whole host of problems. Just don’t. Don’t bite off more than you can chew to.

Nothing actually went wrong there.

No, fortunately. But I kept the models, kept everything for seven years and always wondered, you know, every time I opened the cupboard, I saw the models there. I’d be wondering whether this was going to come back to bite me.

That sort of that unknown is actually, you’re right that not knowing whether it’s going to come to bite you might be even more painful than it actually coming to you. But but but what about when something’s gone wrong? I mean, the level of implantology you’re doing stuff must have gone wrong, right? Yeah.

So, I mean.

You’ll there’s one that we can learn a lesson from. Like someone could learn a lesson from.

I think you have to try and stay calm, even if internally, you know, if the patient picks up that you’re shitting yourself, then I think that becomes a problem. Right? So we will all come across things that become very worrying. I’ll give you an example of a something I hadn’t seen I haven’t seen since, but lower anterior mandible. Prepping an osteotomy for an implant. There’s an artery there that haven’t an arterial that I haven’t seen. And suddenly there’s blood literally squirting pulsatile blood going halfway across the room in squirts like a water pistol being shot out of her mouth. And my nurse is now just suddenly looking at me, panicking. I knew what had happened immediately. I hadn’t seen the vessel on the CT scan, but there’s only one thing I could do. You need to plug that hole. Well, luckily, you keep calm. What’s going in the hole? The implant is going in the hole. Just keep calm. Widen it and put the implant in. No more bleeding. But it’s very easy suddenly to panic and think about cauterising and, you know, trying to ligate vessels and all sorts of things that you couldn’t possibly do for an interosseous vessel. You just have to keep calm. Similar things will happen when you open sinus windows. You know, there are small vessels that you can often pick up if they’re intraosseous, but if they’re actually sitting inside, you’re not going to see the soft tissue on a CT scan. You’re not going to see that. Have you seen it before? Had I seen that sort of pulsatile blood? No.

Yeah. So how did you know that? You just it seemed obvious to you that putting the implant in was going to stop.

It every time the patient’s heart’s beating, this thing is squirting out that sort of pressure. I’m not. I’m not kidding. About three metres across the room, that’s how much pressure there is. Right? So.

Oh my God.

That’s no way that that’s a, you know, a that has to be arterial. Right. So yeah. So you know what’s going on there. But it’s happened when I’ve been mentoring as well. You know someone’s hit a vessel up in the sinus, it’s bleeding and they’re panicking, they’re worrying. You’ve got to stop that bleed. And whether that’s bone wax, cautery, whatever you choose to do, you need to have a variety of tricks up your sleeve to stop that. I’ve had phone calls at 130 in the morning having done an all on four patient is still bleeding. And I said, Oh yes, just a bit of pressure. This. No, She said, No, it’s bleeding like a tap. I’ve had to go back to the surgery and, you know, my wife’s in the waiting room. I don’t have a nurse at 130 in the morning. I’m now numbing the patient up, taking the provisional bridge off, opening the flap on my own. And it was an arterial bleed from the palatal tissues and I had to cauterise that and sew it all back up and put the teeth back in at 1:00, whatever it was in the morning on my own. So these experiences, you do learn things from them.

Well, that’s give me a level of PTSD I wasn’t expecting to get today.

I mean, the other things like membranes and the sinus blowing out, you get the big blow outs and you kind of need to know when you have to close up and come back. It’s not often, but every now and then you’re going to get one that you just have to close and come back to later on. So I think. What is it better?

Was there. Was there ever. Was it sorry? Was there ever a time where you were doing a particular treatment modality or using a particular system or technique where you did it on lots of patients and then you saw them come back systematically and you realise, Oh, what have I done? Does that ever? Because I remember I used a particular material that, you know, they said, Oh, this brilliant amalgam replacement composite packable stuff. And you know, I was a young dentist. It was not like I did loads of stuff, right? I might have done 30 fillings with it. But then I realised, Oh, wait a minute, they’re all failing, this is crap. Or the way I’m doing it is crap. But you know, that’s, that’s 30 fillings. Did you have that sort of situation with implants and thinking there’s ticking time bombs when something new has come along and you’ve jumped on it? Yeah.

So I’ve had the experience with a material that I won’t name, but it was a synthetic graph material. I don’t think it’s even available on the market anymore, but it seemed really nice and easy. You could inject it. It was set hard and it was some sort of beta tricalcium phosphate and beads I seem to recall, and every case that I did with this would come back and there’d be no bone afterwards. So I very quickly learned, I mean, it took a number of months because that’s how long it takes to make new bone. But when I wasn’t getting any and look, it may not be the material. I think we forget sometimes that it might be in my hands. That didn’t work. Technique Yeah, exactly. But yeah, I had to go back to what I was doing beforehand. But the reason the attraction of the synthetic, of course, was not having to have the conversation about cows and pigs and things with patients.

Yeah, yeah. And so, you know, being a sort of near the top of something like, like implantology, there’s that sort of moment of trying something new or sticking to what you know. Or you could say the same thing about analogue and digital, right? But, you know, it’s I find it a funny thing. The closer you get to being near the top of something, the more you’re going to have to try things out that aren’t necessarily researched properly. So I think.

We’re quite lucky. Martin We get involved with a fair few clinical trials stuff that’s not on the market yet. We get to try that out. And, you know, the first time we had to apply for Ethics Committee approval and things for this, it was it was a huge learning. It takes forever hours and hours of form filling, going back and forth with various stuff. And the companies help you, of course, but you have to do it because the company is overseas somewhere. You’re in London, the Ethics Committee is your local ethics committee. But yeah, we’ve got that down. You know, we know what to do now and that means we get to try things with ethics approval when new things are out there. And that’s quite a nice thing to be involved with. We enjoy that. Other times we get to try things that have been approved for launch the approved clinical products, but they’re not released to market yet. We get to play with those sometimes. Do the initial sort of one year follow up, five year follow up stuff that is needed for that. So that’s part of the fun for us.

Yeah, Yeah.

But I think in the UK we do have to be a little bit more cautious and perhaps other parts of the world if you’re going to start being innovative, doing things that are not tried and tested. You know, we work in a very different regulatory environment than perhaps. Other countries, and I think that can stifle progress and innovation.

So. So you detailed there a clinical error and a patient management error. What about if I said business error? What comes to mind?

We too many over the years to count. But I’ll give you 1 or 2 things that perhaps. We have. Done or not done as well as it could be. We a few years back we decided to relocate our Clapham practice. And we wanted a bigger site. Basically, it was double the number of chairs and we thought, this is simple. It’s just relocating a practice. The maths is all the same, but it’s not. You know, the building’s different, the cost base is different. And we didn’t really realise why certain things weren’t working for the first year or so till we realised, hang on a second, this is a effectively a completely new squat practice and that’s how you have to treat it. And that was a huge mistake. So what, you.

Mean you didn’t expect it to be like that?

Yeah, I think the the metrics are different. You know, we try to model it. Martin will sit down, you know, having built squat practices before. But the assumption in my mind certainly was that this was, you know, we’ve got an existing practice. These are the numbers. We’re just going to move all that across to a new site. And we’ve got a couple more chairs here. So that’s all that’s happening. But it wasn’t it was effectively like building a completely new practice.

So. Okay. What else comes to mind?

Yeah. So we’ve also taken a little foray into trying to build a facial aesthetics practice and. Didn’t perhaps do our homework. The idea was that that site we vacated in Clapham, we would keep a hold of it and build a facial practice there. Some of our clinicians were delivering this sort of dentistry already. But Martin and I don’t do any facial aesthetics. We’ve got some clinicians who do that sort of work. We hadn’t really realised what that market was fully about, perhaps, and we certainly hadn’t researched the level of investment that some of the hardware, the lasers and other things that might require. And that was a costly mistake. We started building a business. We started marketing for patients. People would come in, but we didn’t have the hardware to deliver what they they all wanted. These were savvy customers. They knew what they wanted. We hadn’t done our research fully. So I think that was a very valuable but expensive lesson.

So, you know, when when you’ve made this sort of highly successful group of practices now and you must look you must look back at that with some justifiable sort of pride. But when you think back on it, what what gives you the sort of I mean, if we’re talking the other side of it, sort of the most pleasurable memories you’ve got from building this?

You know, I’ve got to go on a journey with. I know they say don’t go into business with your friends, but Martin, I enjoy building sort of new practices starting from scratch. And that does excite us. And we’ve got to do that several times over now and, you know, back in the day. Yes, the families unfortunately suffered because we were spending far too much time with each other. We’d be at the practice till 11, 12:00 at night doing some work, whether it’s paperwork, spreadsheets or even around the practice, adding something or building something. But that journey and getting to go on that with Martin is certainly has been fantastic and I’ve thoroughly enjoyed that. In terms of pride, I’m not wired that way, to be honest with you. I don’t really sit there and sort of look back at achievements in that way. But I think winning practice of the year back in 2017, that private dentistry awards and best referral practice that same year was something that for the team and Martin myself was a real high really was proud of that.

What else. What else. What other high points.

High points. Yeah. I think, as I say, I don’t reflect in that way. Payman But. The pleasurable things for me are certainly that we’ve successfully built. A referral practice within a general practice. I don’t think that used to happen before we sort of broke the mould a little bit there and that took some active thinking and a deliberate strategy and it was to get local clinicians together, educate for free. We would share, bring guest speakers and a lot of colleagues and friends have given up their time, many of whom you know. I think 1 or 2 who you might even have sponsored on the evening to come and speak for us. But giving that back, but thinking about it from the referrers perspective, just as a patient journey for us is about the patient. We want to make that referral journey as friction free as possible for the referring clinician. And it took time, took a lot of time and effort. We would spend evenings with lectures and then a bit of social activity afterwards with a lot of colleagues, and that takes away from the family time. It’s a big sacrifice, but we’re proud of the fact that I would say over half our business is actually referral business.

Is it really? Wow. Yeah.

And it’s an ongoing thing that we work with clinicians of all abilities to whatever level they want, and it’s something that we will actively always seek to do. We enjoy the engagement with colleagues. Some of them will come and watch, learn, observe. Others just want to send the patient in and you send them back having done whatever they needed doing.

What are the bits of bits of this that give you the biggest buzz and the bits of it that don’t? The bits of it you don’t like doing? What are the bits that come really naturally to you? And you know, you could do it all day and then the opposite.

So the clinical work I really enjoy and I could do all day without breaking too much of a sweat unless I get another arterial bleed or something like that. But the.

Do you mean the Meccano? Do you mean the surgery and the meccano? Or do you mean the patient interaction or both or.

Um, no. I actually mean the Meccano. I mean the actual treatment. Don’t get me wrong, I enjoy the interaction with patients, but of all of those things, doing the active treatment and the surgery side, perhaps more so than the restorative in some ways really.

Zoned into it.

It’s just I find that very enjoyable. I don’t find it stresses me out too much in any way. And, you know, you’re giving back something that people have lost. I think a lot of the patients that we get are really they have a disability. We don’t often see it that way, whether it’s a single tooth or often, in our case, half a mouth, full mouth. You’re actually rehabilitating somebody, giving them back function that they don’t have. And it’s something that we all need to do. We all need to eat. We need to be able to chew our food to get the nutrition from there. And it’s something that we’re lucky enough in our practice to be able to do for our patients.

I think on the implant side, you guys are more aware of that than the rest of us who are not on the implant side. But the lesson should be drawn across across all the different disciplines that, you know, eating, smiling, you know, someone, someone. Laura Horton said something. She said, you know, you could help someone fall in love and have a have a relationship. It’s, you know, understanding that that that that could be part of dentistry. I find the implant guys it comes more naturally to them because they literally have you know people who couldn’t bite into an apple who now can. It’s a life changing situation. But you know, including knowing that makes it a much more sort of worthwhile thing that you’re following. And isn’t it in a way, rather than sort of drilling a tooth?

Yeah, absolutely. I mean, it is about giving people back their freedom, their confidence. There’s a massive psychological element to all of this self-respect. Absolutely. Yeah. And it affects parts of their lives that they’re not going to necessarily share with you and me freely. But there are forums out there, and if you Google things, you end up down these rabbit holes. But I did one day stumble upon all sorts of people problems that people were having in the bedroom because of no teeth or their teeth falling out or whatever it is, whether, you know, some of them. The simplest level would be that they didn’t want to kiss somebody. But this is out there on forums, but they won’t tell you and me. That’s why they’re there.

So you said you particularly enjoy the surgery side. What else do you particularly enjoy and which bits don’t you like?

I enjoy mentoring colleagues and helping them develop their skills. I enjoy building those new practices. I mean, that’s obviously few and far between, but that process I think really thoroughly enjoy. You know, you have a squat site. It’s just a. The black hole, a building you’re pouring lots and lots of money into at the outset, and often a bit of sweat and tears dealing with builders and contractors and things. But when it then finally you open the doors and it’s a real dental practice. There’s a satisfaction in doing that. Yeah. Which I do enjoy. And yeah, so being able to help colleagues and along the journey, once we populate that practice with new clinicians, that’s another part of what I really enjoy as well.

I think that thing you said about progression, it’s difficult in dentistry outside of the clinicians. How do you how do you manage that for your non whether it’s non dentists.

So for our team, we’ve got the usual sort of platforms where they get their CPD and things for free. It’s quite interesting to see who does and doesn’t use it. You can often spot potential in people, you know, the ones that have done all the modules very quickly and they’ll come and ask you questions about it. And there are others who are getting free CPD that they need. They’re not even bothering. So it does give you a little bit of insight into your team. Our team are pretty good generally, but the other thing is that we will actually Martin will have a conversation usually about once a week, once a fortnight about people within the team. Somebody’s leaving. Somebody’s pregnant. Who’s going to take this role? And then we’ll actively seek to develop people. Too often we haven’t got the skills yet. We have to identify courses for them to go on, and they’re always keen to learn. They didn’t think they were going to get offered that opportunity. They’re always very grateful.

Could you give me an example then? Give me an example of where someone started and where they’ve ended.

Yeah. So we’ve got people who’ve started as just a trainee nurse and they will come through that journey, gone on to be a head nurse and then gone on and become a treatment coordinator. And there’s completely different skill sets in all of that, and it’s just taken a number of years for them to go through that progression. But they stuck around. We had another nurse who. Wanted to do. Hygiene helped her along with that. And then she came back and worked as a hygienist for us for a period of time as well. So anybody that wants to progress, I don’t think you should hold people back. I think it was Richard Branson. I think he said, look, train people well enough that they could leave you but treat them well enough that they don’t want to.

Mm That’s nice.

And that’s kind of the philosophy.

That’s nice. So we were doing an interview last week and the person doing the interview with me, so on our side said, yeah, that that candidate was really strong. But in a way I think he was too ambitious for us. And it broke my heart, man. Broke my heart that that’s what she was thinking. You know, you have to try and find someone who’s less ambitious and, you know, and I get what she was saying. She was saying he’s not going to stick around or something. Yeah, but what you just said there resonates. But that’s a nice, nice way of looking at it.

Well, people, I think, might surprise you as well, You know, just because they’re ambitious doesn’t mean that they’re going to run off. And if they do, one of the things that she said, what gives me pleasure, one of the things that really is quite pleasing and it’s happened only last week. We’ve had a number of people leave us, go off and do other things. And I’m talking, you know, ten, 12 people over the last 20 years will then come back and want to work with us again because the grass is always greener, right? Yeah, but they’ll have gone. Feels good, doesn’t it? Yeah, but they come back and it’s always amicable, you know, The parting is never acrimonious. Most people get a little send off and drinks and all the usual things, and, you know, if they deserve it, the reference, all of those things. But then have some of them come back and say, look, I want to come back and work for you. That’s really quite pleasing.

Yeah, that is nice. I feel like that with people who leave Enlightened and come back.

So your team is about as big as ours now, isn’t it?

It’s about the same. About the same 50 people. No, but I meant customers. Meant customers. Oh, we’ve. You know, there’s always some accountant somewhere who goes, Why are you paying so much for your whitening? You know? And then you get someone. Maybe, um, we’re coming. We’re coming to the end. You didn’t tell me which bits of the job you hate.

You know, the bureaucracy. Sometimes I think most of us who are clinicians, and that’s kind of where I started out, that the business acumen and all the other things and the academies and things. That’s the secondary thing. I’m a dentist first and foremost. Yeah, the regulatory stuff, stuff that gets in the way. I just find that onerous and a little bit frustrating at times. It’s just the way I’m wired. I mean, we all have to do it. Look, I get that we need regulation. I don’t have a problem with that. Yeah, but I don’t see the sense in all of the things that we’re asked to do sometimes. And that frustrates too. So that part of the job I don’t particularly like. Other than that, there’s not a lot you know, I like a varied week and being able to do a bit of HR and a little bit of finance and a little bit of something else and some clinical dentistry along the way and maybe some mentoring or helping or looking at a case with a colleague along the way that that I think the week goes nicely like that.

Nick You know when I think about people who managed to become presidents of stuff and, you know get up that ladder if you like, I somehow always think there’s some sort of a machiavellian sort of skill if you want to look at it that way, you know, you’re good at that sort of thing. And I don’t mean to make it sound like because because I think you’re completely the opposite. This is my point that, you know, you’ve managed to get to the top of stuff without having sort of what I would consider the skill set that some people have to have politically to sort of, you know, manage things. For instance, you know, you have to get to the top of stuff. You need to sit in meetings, for instance, for the sake of the argument. Yeah. And I could never do that. That would disqualify me from the beginning. From the get go. I can’t even sit and have a meeting about like, the subject that interests me very, very much. You know, like the most important subject to my to my life. I can’t sit. So. So I would get disqualified. But. But what would you say to someone who wants to get involved?

So I think the first thing for me is why are you doing it? I mean, there are people you’re right, they’ve got ambitions. They see it as a badge of honour or something they can put on the CV and use and leverage. It’s never, ever been about that for me, and I’ve never used it in that way wherever I’ve been. You know, it’s for the good of the organisation or the way I see it, I’ve always seen it. I beg your pardon is maybe, like I said, this is going back to my dad’s teaching. If you get to the top of that organisation, you’re there to serve those members of that organisation and you need to think about how you best serve them, what do they need, what do they want? And sometimes that involves asking them. Taking a survey, whatever it is. But my job as a leader within any organisation has always been there to look after those people within the organisation. It’s not there to serve my own purpose. So if somebody young wants to get involved and you know, we’ve always been at the back, very progressive as you know, we’ve always had students engaged and some of them now are president of the organisation etcetera. That’s amazing to see that an organisation like the BCD within 20 years has taken Dental students through from their undergraduate days through to leading that organisation. There’s so much talent in that group of people there and the reasons they want to do it. I think for me at least, the majority of the reason needs to be that they want to give something back. Not to take something out, they will get a lot back for themselves. Invariably, you network with people, you make contacts, you get advice that all just comes, but do it for the right reason.

Okay, I get that. But what I’m saying is that to me, I would think that the kind of person you are who’s who’s not particularly sort of forceful or, I don’t know, in a situation, I don’t think you would be the one to raise your voice or, you know, be be be the outspoken one. You’re just calm, nice, you know, common sense guy. I’d imagine that person can’t get very far in a in a situation like BCD or whatever, in a situation where it’s by votes and by nominations and. But I’m wrong. Yeah. You manage it. You manage it so you make it look so effortless. But that’s that’s what explain that. Break that down for me. Am I first of all, am I completely wrong that it it doesn’t take a loud, you know, sort of influence the type of person to to move in these circles? Or number two, is it that you’ve just managed to dance on this needle more more elegantly than most?

I don’t know. I mean, I’ve never thought about it. I’ve always felt that in some way, shape or form, I’ve ended up in these places by accident. But the accidents keep happening. So you’re probably right that it’s not necessarily accidental. I from a relatively young age, I’ve been involved with organising things like this, whether it’s at school, whether it’s in my local cricket club, whatever it is. So, yes, you’re right. My style is not generally to to shout or be forceful, but I think there are different ways of leading and. People often will listen to the silence more than they will the ranting and raving. If you’re going to raise your voice. I think actually keeping quiet often speaks way more than than raising your voice or shouting or anything like that. But I think leadership is about getting people to come along with you, right? So, yeah, by and large, everything that has ever happened in the organisations I’ve been involved with will be by consensus. Of that group of people as to why they would vote for me to then be the head of that. I can’t answer to their thinking or rationale.

When you say consensus. Consensus implies you have a vote on every decision sort of thing.

No, not necessarily.

Leadership, is it?

No. You will propose something and you’re going to tell people what you’re going to do. But if they completely oppose it, you won’t get that show off the road. Yeah. So what I mean is that you need to have enough persuasion to get your ideas across and to explain the rationale behind them and the benefit to the academy or the organisation or whatever it is that you’re doing your practice, you know? Martin, I have to have these conversations. He has ideas that he has to persuade me about and vice versa. Some of my ideas are crazy and some of his are not always brilliant, but we talk about them. But before we go ahead, we do need that consensus between us. To implement them in the practice, right? So I couldn’t tell you how I end up heading these organisations. It isn’t a deliberate sort of. The strategy. It never was. Never has been.

But what’s okay, what’s what’s your particular. The word is wrong. I was going to say bugbear around these organisations. So, you know, unlike the rest of us, you and about 14 other people are able to say, right, my vision for the organisation is X, Y and Z. So what did you say on that day or what do you think? Like, you know, ask me. I’d say the events are too boring, you know, there should be more exciting. That’s what I would come in with. But. But that’s me. What did you say? What would you say?

Well, I think one of the things you’ve got to realise is that. Time is precious and depending on the organisation, you’re not going to be at the helm for an awfully long time. You have to be realistic about what you want to do and obviously there’s a journey, right? So you don’t end up as the president of an organisation on day one. You don’t just get voted in from the floor, you’ll have served on a committee, you’ll have seen how things work. So you know which buttons need pressing to get certain things done. And there’s usually a 2 or 3 person. Line to get to presidency that might be president elect or often it’s the Treasurer then becomes the vice president and etcetera. So you have a bit of time to work out what your pet projects for your period in office are going to be. And I think the key to anyone who’s going to do this is to identify what those things are going to be before you get there. Do a little bit of your own homework and then when you get there, you can actually explain it. In the right way. Get it done. But be realistic. I mean, if you’re in office for a year. With certain things. They’re going to eat up 90% of your time before you. You’re suddenly past president before whatever you want to do gets done.

He is not very long, is it?

A year is not long. At Bard. We have two years recently that that was broken. Nadeem Younis because of Covid had an extra year. So he’s probably the only person who served three years at Bard. I think at the outset, at the BCD, we needed a little bit of a steady ship. Chris was there for 3 or 4 years at the outset before he handed over to David Bloom, as you know. Yeah, but that any new organisation needs that. So what did you say.

You want to change? What did you say and what did you did you manage to, to to achieve what you thought you would? Or was it the opposite? Did you find it very difficult to achieve the things you wanted to achieve.

At the BCD? I’m not sure I changed an awful lot as president. A lot of those ideas were used up along the way. You know, I was on the board for over ten years, right? So.

Yeah, yeah, yeah.

Those things that you want to get done. We’re all ready. The ideas get used up. And this is where I think you need new people. I think you also need an element of younger people who may be a bit more savvy with certain newer technologies and social media and things coming on board in organisations to keep it fresh and relevant. And they’re the ones who are going to have new ideas. I mean, if you cling on and want to drive the car from the back seat as a past president of something or other, there’s something wrong. You need to let you know you’ve got enough young people with talent that you’ve brought on board. Let them run the show. And unless they’re doing something catastrophic, why would you get involved?

And he’s been very good at that.

Yeah, absolutely.

The execution has been excellent on that. And it’s nice to see new faces. And I always think it’s a combination of good old faces like mine and yours and then a few new faces. That makes it more interesting.

But last couple of years it’s been interesting. I mean, there’s a lot of new faces that wouldn’t know who Payman is or Nick is. I mean, that’s, you know, 20 years on. Well, yes, it is nearly 20 years old. Right. So, I mean, there are going to be a lot of younger dentists out there who wouldn’t know who the president was in 2003, 2005. Right? Yeah. And that’s fair enough. That’s okay. Bard is a much smaller organisation. We are probably only sort of 90 odd members, but clinicians of the highest calibre all wanting to deliver dentistry at a really, really high level. Presentations. As you said, Martin’s presentation was world class last year really was phenomenal. And it’s that sort.

Of education so high, the standards so high. You know what you said before that it was a bad event that kind of changed your thinking? Yeah, I completely remember exactly the same experience. And it was a bad event. It was at the Millennium Hotel in Gloucester Road years ago.

Yeah, that was the one. That’s the 10th anniversary. Was the one. That’s exactly. I didn’t realise you were there.

Yeah, it was the first time I’d heard the word zirconium for a start. And it was. It was all over the. I mean, the presentation blew me away completely. Blew me away and save me like it.

So that was John McLean talking about Zirconia and the guy, you know.

Just.

Oh, yeah. I mean, these guys were just so funny.

It’s a living legends.

Yeah. So it was the same event. But so change is potentially a little bit easier at Bard, but Bard’s also. In some ways a bit more traditional in its structure and culture. So there’s not a lot you want to change. And it is very much about academic excellence, clinical excellence, and there’s not much you know, the formula is not broken. You don’t want to really fix it too much.

Yeah. So now going forward. What can you tell me? What are your plans?

Yeah. So as I said to you earlier, I mean, we have ridden out the wave of Covid, and our plan is almost certainly to look at expanding our practices. We certainly enjoy building practices. Timing wise, not certain, but I think we will certainly be looking at that. And that means we’re always interested in meeting young new clinicians, whether they’re specialists or general dentists. We want to come and work with us. And, you know, the same that we’ve given everybody that’s been through the practice in the past will never hold them back. We’ll always want them to fly. And if they choose to fly solo somewhere else, that’s okay. They will go with our blessing. But we look forward to that next stage where we can maybe add a practice or two to the group.

Nice. And what will you do to stay in the same sort of South London? Is that is that the way you’re thinking? Keep them all close, like dominate that area sort of thing.

We toy with locations. We haven’t got anything solid. We haven’t actively started looking yet, but we will at some point. But yeah, you know, within London for sure. I don’t think either of us got the energy to to commute further than that.

Yeah, I get it, man. And any thoughts of winding down as in, you know, like at this age, me and you, we get to see some of our colleagues, right? I see people. People I went to school with talking about retirement. Do you feel like that you’re anywhere near that or do you love it too much and you’re going to carry on into your.

So certainly love the clinical dentistry. And I think we all have to at certain point think about that journey because it isn’t an overnight journey, right? It is exactly that. A journey of maybe two, three, four years, depending on whatever deal you strike with whoever is going to acquire the business. I think Martin is still relatively young. We’re only just turned 50 not that long ago. There’s a few few more years left in us, and at this juncture, we’re looking to to build what we have, really, and. We will have to start talking to each other. Hopefully our timings are in sync. You know, that’s always an issue when there’s more than one partner in the business. But. It will be together. It’s never going to be that I leave and Martin’s around or vice versa. I can’t see us doing that. So it will be a joint decision whenever it happens.

To do you think like that? When when that day does come? I think about it for myself. There’s an element of especially with a business where it was squat. It’s like your baby that you’re giving away. Do you think your is sort of who you give it away to rather than the amount of money?

Now, look, money’s always got to be right. I mean, at the end of the day, you sweat for this. You sacrifice all of that family time, often your health, mental and physical. In order to do these things, the rewards have got to be there. If not for ourselves, certainly our family’s security. You know, it’s your pension ultimately, for most of us, right? It’s dentists. And the flip side of that, though, is that, yes, it does matter not because it’s my baby or Martin’s baby, but there are people in that building that have loyally given their time and their sweat and tears to us. And we want to make sure that they were well looked after, whether that’s the clinicians or the nursing staff or the reception team or whoever it is. So that bit does matter. And the likelihood is that we’ll want to work in that business for it might be a day or two days a week or whatever it is for a period of time. So you don’t want to work somewhere that you’re not going to be happy just for money. But ultimately the money has to be right to.

It’s interesting. I mean, I’ve heard of people sell their practices and then depressed straight afterwards. So it’s an important thing to to manage correctly. The nice thing is it’s not like the valuation of this business of yours is is at risk. I mean, there’s the know, there’s gross economic risk, right? But it’s not like there’s going to be some sort of competitive risk or anything like that. So you can you can rest easy on it. But I’m so proud of everything you’ve achieved just in the time I’ve known you. So I’ve probably known you for half of that career of yours. Yeah. And watching the two of you turn each of these places into places where people are happy, patients are happy, staff are happy, and then achieving these brilliant things. It’s been a real pleasure. And as I say, keeping your humanity and kindness. You know, one of the easiest people to talk to, having achieved all of that. You know, no ego is rare in our profession. So it’s a wonderful thing. Man. I’m going to end it with the usual questions. I don’t know if you had anyone sent these to you because it was a last minute thing. But let’s let’s have it. Fresh fantasy dinner party. Three guests, dead or alive? Who would you have?

Okay. One. Unfortunately dead is somebody. I didn’t get to spend the sort of time that I would have wanted to. It’s my maternal grandfather. This guy was really a phenomenal guy and that the little bit of time that I did get to spend with him was incredible. He was you know, he could be a five year old kid with a five year old kid and be the mature old man that he needed to be with with that age group. But he wasn’t particularly well educated, didn’t have that opportunity. However, he had and maybe this is where I get it from these skills that you’re asking about to bring people along on a journey. He somehow could get the most sort of stubborn person. You just sit them down, have a cup of tea with them and have a chat and within ten, 15 minutes they’re doing whatever he wanted them to be doing. And it was it wasn’t for his own gain, by the way. It would be for their own benefit. You know, they’d be doing something daft. And he’s trying to steer them back on course or save their marriage or whatever it is. That little bit of counselling and therapy along the way. But he was hugely entertaining. You know, we’d have a story.

You could sit there and listen for hours and hours so that somebody that because he was in India and we were here, I never really got as much time as I would have liked to have spent with him, whereas my dad’s father was was in the UK with us. The second person I don’t know whether I would like this person or not, but I would like to have dinner with them. It’s my one of my favourite authors, a guy called William Boyd. I’ve read pretty much every single book that he’s ever written and I get deeply immersed in these books. These characters just come alive in 3D for me, and it’s a skill that not all authors have, and they’re also very, very well researched books. So there’s historical context and accuracy and things in there. It just is an incredible writer. If you haven’t read any of his stuff, do ping me a message. I’ll send you a couple of titles. But he’s somebody I think I would find hugely entertaining, lived around the world, lived in Africa, seems to have spent time in each and every place that he’s written about in the books. And it’s fiction, but there’s a lot of historical stuff along the way, which I find fascinating.

What’s your favourite book by William Boyd?

My favourite book by William Boyd. Any Human Heart. And they turn they televise that a few years ago. I think you could probably still stream it somewhere, but read the book first. And the third person. A giant of implant and surgical dentistry. A chap you probably have heard of, a guy called Oded Baart who set the sort of twilight end of his career. He’s out in California. Periodontists by training. But. On the few occasions I’ve had a chance to see his work. It’s just incredible. And it’s not the clinical stuff because there’s lots of people doing this, but it’s his thinking, the way he thinks about the case and the way he thinks about that problem is just different to anyone else I’ve seen. I can’t explain it, and I’d love to spend some time with him over dinner and try and get inside that head and understand what he’s thinking when he sees a case.

Another one of those South Africans done good in the US. Yeah. Like Ellen.

Yeah.

So what? So clinically, he’s your sort of your hero?

No, no, not at all. I mean, there’s too many of those. Who did you say?

Throw out some names of those people. Clinical heroes.

Heroes. Look, I’ll give you somebody whose work I think is just absolutely phenomenal. Every single case that I’ve seen him do. Eric Van Doren, who I mentioned before. Yeah. Here in the UK, you know, friend and mentor to a man who I think is someone who probably doesn’t get as much airtime as he deserves in the UK. Those two guys, their ability to look at a case and take the worst awful cases and make them look the way natural he should is incredible. There’s lots of other speakers that I could throw out there. There’s there’s too many to list.

A lot of integrity there as well. Right. With them to do in my dealings with him. All right, man. And the final question. It’s like a deathbed question on your deathbed, surrounded by your loved ones. Three pieces of advice you’d leave for them and for the world.

For the world. I don’t know. I mean, you know, my family. I know I can give them some advice. Perhaps the first one is actually a little bit almost of an oxymoron type thing. I was going to I would tell my kids in particular to keep their own counsel. Ask for advice, ask for help, listen to people. But ultimately, you’ve got to make your own decisions, keep your own counsel. And I think trying to help them grow up where they’re not afraid to fail. They haven’t got fear of trying. Those sort of things, I think are very important to me. So I’d want them to be thinking for themselves.

How do you instil that? How do you how do you encourage that?

You know, I think it’s difficult. We all start off as parents. There’s no proper manual for this. Right. And, you know, you love your kids. You want them to do well. But I think a lot of us might be a little bit too guilty of protecting them, a bit too much. And we kind of tell them to do things rather than asking them questions around things they want to do and having that conversation. And I’m guilty of this, by the way. It’s only in the last five, six years when my kids are older now that I’m thinking this way. But I wish I had a lot earlier and they’re both pretty confident. I think we’ve done a pretty decent job along the way, but I think it can be taught. I think that this thing about fear of failure, it’s no good when you’re 30 and as a businessman thinking, yeah, you need to be taught that from a young age.

How old are your kids?

So the older one’s 19. She’s at university. The younger one is just about to start her second year of A-levels later this week. If the concrete.

Budding dentists out there.

No, no. The elder daughter is currently doing theatre and performance, but who knows that that could turn into something to do with that or acting or something completely different. And I think, you know, in our Asian culture, Indian culture, I don’t know if it’s the same in Iran and things, but it’s doctor, engineer, lawyer, that sort of thing. And so the reason I’ve worked so hard is to allow them to have the freedom that they do what they want to do and get good at that. And, you know, they will flourish in that.

So I’m really interested in that question of, you know, first generation, okay, get it. Second generation. How many generations does it have to go on for? To go for only these safe bets? You know that the day when the day when you. Turning up to a dinner party and saying my daughter’s in theatre is a thing where people will say, wow. And if you said my daughter’s a dentist, they’d go, Oh, it’s a bit boring, you know? When’s that day coming? Because not all, not all, you know, Easterners believe in letting their kids into that sort of thing. Did you have to struggle with that, or were you totally the other way?

No, not at all. I mean, my parents didn’t ever, not once, tell me what to do. Oh, really? No, I think they’re probably hoping that I’d go into a profession, whether it was accountancy or law or medicine or whatever. Not. I don’t think it’s to do with any actual sort of snobbery around what you do. I think it’s just financial security, ultimately. True. You know, they know that you’re not going to starve. You’re going to have three meals and if you’re half decent, you’ll always be able to do that in those professions. So I think that’s all that underpins that. As to when will that I think that tide has turned. Certainly if you think about some of the younger Asian dentists that you and I will know, they all come from families now that are second or third generation parents have done okay. There’s a bit of financial independence and backing if they need it. I think it has happened. And, you know, there you go. My daughter’s an example of that.

Yeah, but the ones the ones we’re talking about are they’ve studied dentistry, right? So, you know, they’ve continued I’m saying I’m saying break with that. So the fact that your daughters I mean, look, by the way, by the way, my my son is about to embark on A-levels and my daughter’s 14, and neither of them want to be a dentist. And I feel like a failure because of it. So somehow I feel like we failed. Both me and my wife are dentists and all that. I mean, my son says, Look, I actually do want to do what you do. I just don’t want to do what Mum does. And, you know, Mum’s a real dentist. But anyway, let’s, let’s carry on. Other pieces of advice. So think for yourself. Love that.

Yeah. And then the next one I think is something that this journey that we will embark on as youngsters, we really don’t understand. And nobody told me this and I wish they had prioritise and invest in your own health and well-being. I mean, I just think all of this is for zero if you’re not able to enjoy it physically or mentally. I’m very lucky. I’m fit and well, but the number of people. That you see along the way when you start getting to our age that are either physically not able to do things that they like to do or would like to do, or they always thought they’d retire and travel and do these things. It doesn’t happen because of health. So I think that that’s something that they really do need to understand from a relatively young age as well. And then finally get comfortable with being uncomfortable. I think that I was listening to another of your guests that you had on a little while back, and she was talking about learning to say no. But I think that only comes after you’ve learned to say yes for a period of time. I think you have to say yes. So I wasn’t a teacher. I wasn’t a lecturer. Somebody from an implant company approached me at a time when I didn’t even know what PowerPoint was. I didn’t have a laptop. And they said, Will you teach? What are you talking about? I said, Will you doing all this implant work? You’re photographing it, will you? Teach others how to do that. And uncomfortable as it was, I said yes, I’ve never looked back. I had to then go and ask Martin what laptop to buy and what is PowerPoint. But that thing about opportunities don’t always come knocking twice. You’ve got to learn to say yes to a few things before you develop that skill. To say no afterwards when you get busy, your plates too full.

It’s a very good point. It’s a very good point. It’s become very common, very, very fashionable to say, hey, you learn when to say no. But you’re quite right. That’s after you’ve said yes a lot. It’s been a massive, massive pleasure talking to you. But I think we’ve gone for two hours and it’s just flown by. Completely flown by for me. Thanks a lot for taking the time to do this and keep doing what you’re doing, buddy. Keep doing what you’re doing. We need more, more, more like you in our profession. So thanks. Thanks so much for doing this, bud.

Absolute pleasure. And I’m sorry it’s taken me so long to actually sit down and do it with you. You’ve been asking for so long, and I haven’t been avoiding you.

Both of our faults.

All right, well, look, thank you so much. Great fun. All right. Thank you.

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.

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On the landing page. What’s really important right at the top. Clear call to action. Phone number button to fill out a form. Your contact. Your location. Right. So your address. So they know where you are. Okay. The offer that’s at the top and perhaps some social proof wires, some information about the steps that happens next. What happens at the consultation, some information about the treatment, maybe some FAQs, some information about the clinicians involved. If you’ve got won any awards, there’s anything unique about your practice, make sure that’s on the landing page. If you’ve got some before and afters of patients that have had that specific treatment, pick your best ones. Put it on that landing page. If you’ve got any Google reviews of those patients who’ve had that treatment, put them on that landing page. If you’ve got video testimonials of patients that have had that treatment, same again. So that landing page is all encompassing and that patient should have no reason to look elsewhere for that information.

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.

Welcome to the Dental Leaders podcast. Today I’m going to be touching upon marketing, and it’s going to be a session where we go through a few key questions that have been coming up when clients have been getting in touch with my agency, jumping on discovery calls with myself to explore lead generation, the possibility of our agency running Facebook ads, Google ads for them, and speaking to them about how we can help them implement things like CRM systems to essentially maximise the return on investment from their existing marketing strategy. There are a few common questions that keep coming up, and this is what I’m going to cover today. So what are the key differences between Facebook ads and Google ads? Which ones should I run if I want to get more implants through the door or all on four cases, same day teeth cases through the door? Should I be advertising on Google or Facebook if I want more Invisalign inquiries through the door and I want to mark it in a in a region that’s my local area and beyond. Is Facebook the best way to target that or is it Google ads? So so there’s a lot of questions around should I go Facebook? Should it go Google? Should it be both? And landing pages versus sending traffic to your website? Now, for those of you who are not sure what the difference is, a landing page is a highly targeted page that has usually has an offer on it, but the focus of that page is the treatment or the service that you’re advertising, nothing more, nothing less.

They can’t navigate to other pages, find out pricing structure and other treatments, can’t start looking at your awards pages, etcetera, etcetera. I’m going to talk about landing pages and structure conversion data tracking conversion. So a lot of agencies will send you reports typically at the end of the month or the following month for the month before. So there’s a few questions and topics I want to discuss here. First of all, how you should be monitoring your marketing and measuring it month to month. Should you actually be measuring it month to month? And what is a conversion and how should you track a conversion? And it means different things at different stages during the digital patient journey. The next topic I’m going to be covering is the concept of giving leads time to convert and long term nurture what you should be doing. And then finally, the topic of ROI and how you should or how you could go about calculating marketing return on investment should be should we be looking at this data at the end of every month to calculate the ROI for the month before? So we’re now in September. Should I now be looking at my data for August and seeing what the ROI on my August marketing spend was? Or is that the incorrect way of doing it? The fact that I’m asking this question will probably give the answer, but we’ll dive a little bit deeper.

Okay. And those are the key topics I’m going to be covering and maybe some other things will pop up whilst I’m talking. So Facebook ads versus Google ads, what the key difference is. So when a client asks me, should I be running Facebook ads or Google ads? And depending on which treatment or location or whatever. My answer to that question, as with most questions that clients ask me, unfortunately, is it depends. It depends on what your budget is. It depends on how quickly you want a scale. It depends on if you’ve got the infrastructure and the team to manage those inquiries. And it depends on if you’ve got a team and an infrastructure who can manage only high quality inquiries and I’ve only got the time and bandwidth for that. Or you’ve got a team who can filter through high volumes of inquiries and dig for the gold. Okay. So often when we’re speaking to potential clients about running ad campaigns for them, one of the key things that we want to learn about is the business, the structure, the infrastructure, who’s on your team, who’s following up inquiries, what their skill set is, what their level of resilience is, when they, you know, can they. Have they got the capacity to ring 50, 100, 200 leads or inquiries over a certain period of time and follow them up and chase them and text them and send them whatsapps And send them emails.

And calls and multiple calls at multiple times of the day. And once we get an insight into that, then I can answer the question and say, so should we should we be running Facebook or Google ads? On the whole, I can give you some general advice, and that would be that Facebook ads and Google ads vary in terms of the inquiry quality because of the intent of those two platforms. So nobody say nobody, but very few people jump on Facebook and say, do you know what? I’m going to find myself a dentist, I’m going to buy this item or I’m going to buy this product or I’m going to look for a chiropractor. I’ve just hurt my back. I need an osteopath or a chiropractor. What would you typically do if you put yourself in those shoes and you’ve just hurt your back? What would you do? You’d jump on Google, you’d look to find somebody local. You would read their Google reviews and you’d probably make a decision based on that. And that’s what most people are doing with a high level of intent with dentistry. But with Facebook and Instagram, you pop on that platform and you are inundated with smartly targeted ads. Yeah, I’m in the market for a small electric car as a little run around and I am getting targeted with ad after ad after ad for a wide range of different electric cars for different price points.

Used new people throwing technology at me. Et cetera. Et cetera. Right. Why? Because somehow the platforms figured out that I’m in the market for that. Whether I have searched for it on Google or whether I’ve done some social searches, whether I’ve seen some ads, whether I’ve been in a location near a garage where I went to look at an electric car and test drove them. Whatever it is, the systems figured it out and now they are serving me ads. But I don’t go on Facebook or Instagram looking for a new electric car. I go on there to see what my network have been up to, maybe watch some stories, perhaps some work related stuff. But my intention is not to buy because if I wanted to buy, I would jump straight on Google. And so when it comes to inquiries on Facebook, because the intent of me wanting to make that purchasing decision is low and the buying cycle can be so long, right? I could be very early on in that discovery phase of looking for a car. Your potential patient could be very early on in that discovery phase of thinking about Invisalign fixing their crooked teeth wherever they are in that journey. Many patients take 2 to 2 and a half years from the initial intent of thinking about it to actually going ahead and accepting a treatment plan.

And during that journey, patients will make inquiries. They’ll send emails, Hey, if an offer pops up on Facebook for an Invisalign open day, guess what? They might fill it out. They have no intention of attending, but they’re curious. They’ll want to. They’ll want to explore what’s what’s knocking about. They might even speak to you over the phone and not turn up ghost. You never respond to an email. Okay. And so the intent of Facebook ads, because of the nature of them, tends to deliver a higher volume and lower quality of inquiries for the same budget. So if you had a specific budget and you said to me, Look, Prav, I want to generate as many inquiries as possible for this treatment, and the quality of those inquiries is not a concern for me. I would go Facebook ads every single day. And when I say Facebook ads, I mean Facebook, Instagram, WhatsApp, all their ecosystem, right? And when we refer to them today as meta ads, now there are certain things with Facebook ads you can do to elevate the quality of the inquiries that come through. It’s not all bad. So if all you’re putting out there is book a free consultation, usually £75, we’ve got these offers, we’re offering free whitening, we’ve got these discounts. You are going to get those patients who are just looking for that.

However, you can put filters in there, such as what your price points are, what your USPS are. Perhaps you could even have in the advert finance options, you know, and things like filters, right? So on Facebook you can. Have these forms, or you can send them to a landing page and you can get intent for them from them. So you can make them fill out a form that says, Are you serious about Invisalign treatment? What do you know about it? Can you upload a photo of your smile? And if you were suitable for Invisalign, would you be interested in going ahead with treatment straight away in 30 days time? In 90 days time? Or are you just looking for information? Are you aware that the treatment costs for Invisalign vary from point price A to price B yes or no? Have you had any previous consultations? We offer finance for Invisalign treatment that starts from so much per month or you can pay upfront if you are suitable for Invisalign, which option would be best for you? So by asking more and more and more questions during that initial inquiry process, you filter out inquiries. So if you want high quality or Facebook, which is traditionally a high volume platform, ask more questions. The more questions you ask, the less inquiries you you will get, but the more information you’re collecting and the higher the quality of that inquiry will be.

So you can you can add various filters along the way. And that’s typically what we do. If a client says to me, Look, I want to advertise on this platform, but I just want to drive quality through the door. We add various questions, barriers and filters to give us more information about that patient. Ideally, when we’re booking patients in for complimentary consultations in my own clinic, what do I want to do? I want to know some information about that patient before they earn the right to attend my complimentary consultation. I want to know what they know about that treatment. I want to understand how long they’ve been thinking about treatment and the why now. Okay. Patients don’t wake up in the morning, look in the mirror and think, Holy crap, where did those crooked teeth come from? They’ve been there a while, so understanding the why now is really important when we’re booking patients, understanding what they know about the treatment, what research they’ve done, understanding that they’ve got a clear understanding of the typical investments of Invisalign and what the costs would be, and for us to understand what their funding sources would be so we can talk about finance during that phone call. And then based on that, we can ask the patient, would that be something you’d be interested in or would you just be looking at paying up front, as many of our patients do, just by asking that simple question, We get an idea if this patient needs to borrow money or if they’re ready to go and they’ve got the cash in the bank.

So once we know all that information and we book the patient in, there’s another quality level filter at the phone call level. And whether we’re running Facebook ads or Google ads, it’s exactly the same conversation that we’re having on the phone now. When we compare Facebook ads to Google ads, we know the intent is different. A patient jumps on Google and they type in Invisalign near me, best implant surgeon in my area, best implant surgeon in Manchester. Cost of all and for. Dental implants in Manchester, right. They are putting specific keywords into Google. And then based on those keywords, when you’re running Google ad campaigns, you have the opportunity to show your ad to that person who is searching for a specific keyword or set of keywords in your area. So you can tag it based on radius as you can with Facebook and Google. Okay. But you can essentially say I want patients to type when they type in these specific keywords. I want my ad to show and when my ad shows, I want my ad to say a certain thing so it could have an offer in there, it could be a complimentary consultation. It could literally just have some copy in there that speaks to that keyword and asks that patient to discover more or book a consultation or book an assessment appointment, or talk about your five star reviews or your award winning services, whatever that may be.

But the intent is so much more because if I’ve hurt my back and I’m looking for an osteopath in Manchester. I’m looking for an osteopath in Manchester. There’s no there’s no misconceptions of why I’ve typed that search in. It’s not like I’ve jumped on Facebook to see what my mates are up to. So when you get somebody who fills out an enquiry form from Google ads, on the whole, the intent is different, so the quality of the enquiry is higher. We can still add even more filter questions in to elevate the quality of those inquiries. But on the whole, with Google ads, you don’t really need to do that because the intent is there. So hopefully now you’ve got a clear understanding. Facebook versus Google. And the question is which one should I do? Often the answer is it depends. The performance and the success of a Invisalign campaign in Manchester versus Liverpool versus Winchester versus Birmingham versus Solihull. Even if you run the same campaign with the same creative, with similar targeting will be wildly different. So often agencies like myself and lots of other agencies out there will have to do a degree of testing in the early days. The performance and the success of those campaigns will be highly dependent on the local competition, what they’re offering.

Your budget that you’re going to need to put in is going to be based on what is the local competition doing? How many competitors are there? Who else is bidding on the same keywords as you? What offers do they have in place? If they’re offering free consultations and you’re not, you’re going to have to spend a lot more to generate the same number of inquiries. And whereas, if you know you’re both offering free consultations, then the offers are on the table. Ten patients inquire in. They both see. They all see an ad. One offers a free consult. The other one doesn’t. The one that’s offering the free consult is going to get more inquiries. Therefore, if you’re not, the cost per inquiry will be a lot higher. Okay, So in that sense, you know, in terms of which one should I do? Often we have the conversation. What’s your budget? What are you looking to achieve? And we will either start depending on what the budget is, both platforms or one within 30 to 45 days, you’ve got enough data to figure out is this working or not? What type of conversations are we having with these patients? Should we pause our Facebook ads and and put the rest of the budget into Google because we tend to be booking more of those patients? Or should we take the budget from Google and put it into Facebook or are both working really, really well and we just need to tweak things and put some filters in place.

Who knows? Every single practice is different and having this continual feedback loop is really, really important when it comes to the different campaigns that you’re running and the platforms that you’re running those campaigns on. On the whole, what do I get asked for? Same from every practice. I want more implant leads. I want more people who want teeth straightening and bonding. And then some practices will be looking for general dentistry. So patients who want general private dentistry, we do run some campaigns and then there’s some campaigns that we run for some clients that are a little bit different, and we tend to get more success from them because there’s less competition, right? So incredibly nervous patients who are looking for sedation treatment, for example, not many practices competing for that. So the quality of those inquiries tend to be a bit higher. The intent is high. The competition and the choice is low. And so when you speak to these patients, especially the nervous patients, there’s rarely a conversation around price. The conversation mainly revolves around can you meet their needs? Can you help them with their anxieties and can you fix their mouth without judgement and embarrassment from their point of view? So we do really, really well on these types of campaigns. Invisalign open days are all the rage.

Every Tom, Dick and Harry is running them. So if you’re considering running them, just be aware there’s one every week in every area and everyone’s got a different offer, right? So you might say, Hey, I’m running an Invisalign open day and we’re doing a £500 discount. We’re offering free whitening worth 500 and we’re offering complimentary retainers worth 300. And then the practice down the road is offering complimentary retainers worth 450. And instead of offering standard whitening, they’re offering enlightened whitening. And what happens? The general market gets confused because now they don’t know whether your offer is better than theirs. It’s very difficult for them to compare apples for apples. So what does the consumer do? They attend 3 to 4 open days. They then make their mind up. Sometimes they forget what happened at the previous open day. Yeah. And so sometimes you’ve got to ask yourself the question, does it make sense to follow the crowd? Does it make sense to have an open day or do we do something slightly different? And these are all the types of questions you should be having with yourselves internally, your reception team, your tcos, but also with your marketing agency. If you employ one to come up with some ideas and strategies that perhaps are slightly different from the from the classic open day structure, that yes, it does work. Yes, it can be successful. But bear in mind a lot of these patients may be a little bit more difficult to convert, and I’ve just explained the reasons why.

So one of the questions that get asked a lot revolves around the concept of landing pages versus your website. So imagine you’ve got a website and you’ve got an Invisalign page on there and someone goes to that page, but there’s a menu at the top. There’s various items that they can navigate to, such as Look at your fees page, go to your veneers page, go and have a look at your emergency dentistry page. Read the profiles of one of the dentists. Oh, click on an Instagram link and go off to view your Instagram profile. And that patient who’d originally thought about Invisalign has now been all over your website, has learned about you, has gone to the team page, has learned about your values, has watched some video testimonials. But there is a lot of opportunity for them to get lost. The difference between a web page and your website that just has an Invisalign information on there and gives them access to everything else. And a landing page is a landing page, locks that patient in to that treatment or that service and doesn’t allow that user web browser or patient to navigate anywhere else. So what does that mean? Well, if I’m running an ad campaign and somebody has searched for Invisalign or somebody has searched for dental implants, I want to lock them in to that treatment.

I want to present them with all the information they would possibly need on that landing page to make a decision to hand over their name, email address and phone number, and perhaps some more questions that I may ask them, or pick up the phone and speak to one of my team. I don’t want to give them the opportunity to start looking at other bits of information. Learn about root canal, emergency dentistry, read our reviews page because the conversion rate, when you send someone to your website versus the landing page is like night and day. So we find that landing pages convert better. And so what’s really important is the makeup of that landing page. So when someone clicks on an ad and let’s just let’s just stick with Invisalign is one of the most popular or teeth straightening campaigns that we run. And when they land on that landing page, what’s the first thing that they see? Well, it needs to mention that you offer Invisalign. Perhaps it would be a before and after of one of your patients a video. Perhaps it will mention an offer and that you can claim a complimentary consultation. Your phone number needs to be highly visible. Ideally, you’ll be using a unique tracking number so you can know which campaign made your phone ring and you could listen to those calls later to analyse the quality of those calls.

But then a call to action with a contact form on there to hand over the patients or to attract the patients details. Right. And maybe some more filter questions to elevate the quality, as we discussed earlier, what else should be on that landing page? Social proof Google reviews that relate to that treatment in question. So 5 or 6 half a dozen Google reviews that you’ve pulled from Google that mention Invisalign, 2 to 3 video testimonials of your existing patients who’ve had that treatment, perhaps some information about Invisalign and what it is, maybe some usp’s about you. Are you one of these so-called apex providers? Have you won some awards? Who’s going to be the clinician carrying out the treatment? Maybe some information about them, some photography, perhaps a little bit of information about the process, What will happen at the consultation? What are the next steps? Is there an offer that they can claim? Is it limited everything that they could possibly want to know about that treatment, the usp’s of that treatment in your practice and how that works in your practice? Everything should be on that page. They shouldn’t be able to navigate to your website. I would argue they shouldn’t be able to navigate to your social media because the sole purpose of that landing page is to collect their data. Once you’ve submitted that data in, that contact form picks up the phone, you can send them to what’s called a thank you page, invite them to view your Instagram.

You could then send them a link to go and view your website because they’ve already converted at this point. But don’t give them the opportunity to go elsewhere. I mean, one of the things we often get asked for is, hey, can we just put our software of excellence or our dentally online booking link on our landing page? Often advise against this. And the reason being is neither of those platforms offer the opportunity for the ad platform to be able to track that booking. Now, this is really important because the ad platform optimises and works based on conversions. So if someone picks up the phone and calls or someone fills out a contact form on that landing page, we can pass that data back to Google or back to Facebook to tell them, Hey, this person converted. Use your eye now to find me more of these people that converted. And that’s how your campaigns optimise. Now, if that data can’t be passed back, for example, it’s an online booking or if they’ve, you know, filled out a form somewhere else where we can’t pass that data back then, your campaigns can’t optimise as well. There are little tricks we can use based on link clicks and if somebody clicks an online booking link or button, we can send that data back. But that doesn’t necessarily mean just because they clicked the link they booked.

And so if I’m going to put an online booking link anywhere on a landing page, it will be after they’ve submitted the initial information and then I’ll give them an opportunity. Why not book your complimentary consultation straight away and book into our diary using this link to avoid any delays or whatever. Right. Claim your offer straight away and they can do that. You can send them to the website, you can send them to social media. The argument of landing pages versus website. We have tested thousands and thousands of campaigns, hundreds of thousands of pounds of budget split testing. Is it worth going website versus landing? Page In my personal experience, landing pages win every single time. So if you are sending Facebook and Google ad traffic to your website, think again and perhaps give it a try to get some targeted landing pages built and test it and see how the conversion changes. But make sure when you build a landing page or you instruct a company to do this for you, that includes the key elements of what should be in a landing page. So I’m just going to reiterate that again on the landing page. What’s really important right at the top, clear call to action phone number button to fill out a form, your contact, your location rights, your address so they know where they know where you are. Okay.

The offer that’s at the top and perhaps some social proof wires, some information about the steps that happens next. What happens at the consultation, some information about the treatment, maybe some FAQs, some information about the clinicians involved. If you’ve got won any awards, if there’s anything unique about your practice, make sure that’s on the landing page. If you’ve got some before and afters of patients that have had that specific treatment, pick your best ones. Put it on that landing page. If you’ve got any Google reviews of those patients who’ve had that treatment, put them on that landing page. If you’ve got video testimonies of patients that have had that treatment, same again. So that landing page is all encompassing and that patient should have no reason to look elsewhere for that information. And so that answers that question. And the next question that we often talk about is conversions. What is the conversion and what does it mean? Depends at what stage that patient is in the marketing funnel, I would say so no matter what platform you’re on, let’s say it’s Facebook or Google and the patient fills out a contact form or the patient picks up the phone. As a marketing agency, we would consider that a conversion. So a conversion, as I would define it, is a patient who has responded to some marketing that has handed over their contact details sufficient enough for if you wanted to, you could have a conversation with them with a view to booking an appointment.

So you’ve got the name, email, phone number, you’ve got a bit of information about that particular patient and you can contact them to book an appointment or it generates a conversation, a phone call, which is long enough for you to have that conversation with them. So in the platforms, typically what we do is when someone fills out a contact form, we class that as a conversion. When somebody has a phone call with a team member, that’s over 45 seconds. Since we classed that as a conversion, some agencies may class a phone call as two seconds as a conversion. Some agencies may say that actually we class a conversion as name, email and phone number, the minimum amount of information we need to be able to contact them. We may say, okay, we need a little bit more information and every clinic is different, right? So that’s conversion number one, what happens at inquiry stage. But once we’ve got from inquiry to the next step of the journey, what’s what’s a conversion then? Well, the conversion is a consultation, right? So that takes your number of inquiries. So let’s say you’ve had 100 inquiries, okay? And to generate those 100 inquiries, you needed to generate 1000 landing page views. Okay. So your conversion rate from landing page views to inquiries sits at around 10%. Now you’ve got 100 inquiries. Your next conversion that you’re looking at is bookings.

So what’s the conversion rate from inquiry to booking? Now, let’s say of those 100 patients, ten patients decided to book a consultation. Well then your conversion rate from inquiry to booking now sits at 10% as well. Right. If it was if it was five, it’d be sitting at 5%. And then from there, the next level of conversion is those patients who’ve had a consultation and then decide to put some money down and proceed with treatment or book the treatment. Right. And that’s the next stage of conversion. Most practices I deal with track each stage of the conversion so they will track media, spend two inquiries. So then they have a cost per conversion or a cost per inquiry. They will then track those inquiries, conversions of them to consults, and then they will then track consults to proceeding with treatment. Dentists, practice owners, associates will ask me, what is a good conversion rate? What is the industry standard? What’s typical? Answer the question. It depends. How good are your team at picking up the phone and converting those patients? What’s their level of emotional intelligence like? How much time do they have to follow up these patients, to chase these patients, to have conversations with them, to convert these patients? How good are your team who are doing consultations, whether they’re Tcos or dentists? What’s their conversion rate like? What’s the filtering process like before they get to consultation? The more information you’ve got and the more qualified those leads are, the higher the clinician’s consultation rate is going to be.

So it’s a highly variable process with so many steps in it. There is no industry standard, in my opinion. It’s different for every practice, but the beauty is we can tweak every single stage to get the perfect digital patient journey for your specific practice and the resources you have in that practice. What I am a big believer in though, is how you should be looking at that data. So I believe it’s incorrect to look at the data from the previous month and draw conclusions based on that. Why? Let’s say we’re looking at the month of August and we’re sat in September as I’m recording this is the 4th of September today, and I’m analysing my data for August. And in August we had 100 inquiries and three of those patients have gone ahead with treatment. So that sounds abysmal. And let’s say we spent two grand on marketing, right? That sounds absolutely abysmal in terms of cost per conversion. All the rest of it. What’s gone on? Well, the first thing we need to think about is have we given those patients long enough to convert? What’s if some of those inquiries came in on the last four days of August, have we really given them enough time so that we can follow them up, chase them, have conversations, book them in for a consultation, then have a consultation and convert.

Absolutely not. Have we given every, you know, the typical buying cycle? What does that look like when you’re inquiries that were poking around on Facebook? Their intent may have been so low that they’re going to go ahead with Invisalign treatment in three months time no matter what. They’ll go ahead with treatment, but not this month. And so looking at that data in that isolated 30 day window, in my opinion, most practices do it and that’s how they analyse their conversions is incorrect. Because you’re not getting a true measure of your return on investment and you’re not getting a true measure of the performance of your team. Just because we had, you know, your let’s say your dentist did ten consultations and only converted one, and they’ve got a 10% conversion rate. But this ten treatment plans that went out and four of those treatment plans accepted treatment. Four, five and six months later. Now, what’s their conversion rate because we were only analysing the month before. So in my practice and the practice of clients that I work with, I try and educate them to look at their conversion data three, six, nine and 12 months later. And it is surprising what that looks like. So let me give you an example. If we were to look at August’s data today, maybe the conversion rate from inquiry to console and console to going ahead would be underwhelming.

Let’s say out of 100 inquiries, ten booked a consultation and two went ahead with treatment. Now let’s look at those 100 inquiries. In six months time, the data will be completely different because those 100 inquiries will have had six months to convert. And if your follow up team is using a robust CRM system, is following up those patients over six months and not stopping after two weeks, which is what the majority of practices do, then you will convert more of those to consoles. They just won’t convert in that first month. So some patients that inquire in August might have their consultation in October or November, and those patients who had that consultation in October or November may go ahead with treatment the following January. But the conversion rate for those 100 inquiries in August must be attributed with the data that follows through in three, six, nine and 12 months time. And if you are looking at your data month to month, all I would encourage you to do is go back and look at your data from six, nine, 12 months ago and see what happened to those patients. And you will be shocked. You’ll be surprised because your conversion rate at every stage in that journey will be a lot higher than the report you produced for that specific month. A month later, and this is probably one of the first things that I’ll educate my practices that I work with straight away is how to know what your ROI is on your marketing or just in terms of how to know what your true conversion rates are.

It’s to actually look at that data. Yes, look at it the month after. Look at that same data in three months, six months, nine months and 12 months. Now, doing that manually becomes an incredibly laborious task to do and incredibly manual if you use a CRM system to manage that process, for you to automate inquiries and to automate follow ups. So you’re consistently following up with those patients for that period of time, the reporting dashboard will be able to work that out for you. Press a button and it will tell you what happened in that month six months ago. Okay. It’ll tell you what will happen. Well, after the time is gone. What happened? Nine, 12 months ago? Just by the click of a button and the little filter, looking at the dates for my clients, obviously naturally biased. We use a platform called Lead Flow and it works incredibly well to be able to feed that data. Back to you. On what was your return on investment? What was your feedback in terms of, Okay, we spent in that month, we spent a month, we spent £3,000 on Google ads and a month later it only generated two grand. So what would your data tell you? You’ve made a negative ROI.

You have lost £1,000. You put you put three grand in and you’ve got two grand back out of the machine. But six months later, you got 35 grand out because you go back, you look at the data in the CRM system and it actually tells you, hold on a minute, all these patients now converted a few months later and went ahead with treatment. So looking back at that data is super, super important. I think that pretty much covers what I’ve got to cover today in terms of the marketing lessons. And these are the key questions that are coming up time and time again with my clients. Just leaves me to say that, you know, what can you do? What are the action points from from this podcast? Number one, if you’re running Google or Facebook ads, both one or the other, just think about testing and think about quality. If in your marketing campaigns, quality of inquiries is an issue, start thinking about putting some filters in place that can elevate the level of quality. Just some questions that create some friction in that journey so you get less inquiries, but higher quality. Think if you are driving traffic just to web pages, think about implementing and executing some landing pages. Make sure you’ve got a clear idea of understanding what conversion data is and when your agency sends you data or information that, Hey, we’re converting at this rate, what does that actually mean? And then when you’re looking at your conversions for a particular month, look at that data a month later, three months later, six, nine and 12.

And to calculate the ROI, if you wanted a hand with that, utilise an intelligent CRM system, customer relationship management system that will do all the heavy lifting for you and make sure that any inquiry that inquires today you are following them up for a minimum of two years. Sounds crazy. And many clients that I speak to when I ask them, What’s your follow up process? We’ll call them. We’ll text them how many times? Two times. Three times, Four times. And then they ask the question, When do you give up? The really good practice is never give up, right? Because not now to me is maybe later in my practices and in practices of clients that I work with that utilise some kind of automated system to follow up with patients and encourage their team to follow up with patients at various intervals. We’ll consistently be chasing their inquiries for a period of up to two years and patients fall out of the woodwork. And if you still surprised at what Crikey, I’m not going to follow up these patients for two years. Ask yourself this question. Have you ever had a consultation with a patient? Where six months later, 12 months later, maybe 18 months later, they popped up out of the woodwork, just out of nowhere, and said, Do you know what, Prav? I’m ready to go ahead with treatment now.

And you’re like, Crikey, I’d forgot about that patient. I had a consultation with him two years ago. Six months ago? 18 months ago. And if that rings true. Then surely you should be following up those patients for that period of time to increase the odds and the probability of those patients proceeding with treatment? Look, guys, if you’ve got any other questions in and around marketing, tracking, marketing, conversion rates and how to elevate them within your practice or your own practices and your processes, feel free to send some questions in and I’ll cover them on another podcast. I am also running various courses throughout this year and you can find the majority of the courses that I run with the Academy. So if you just go to their website, there’s various sort of courses that I’m running, some on courses, courses on how to convert on the phone. And then next year, early next year, I’m doing a masterclass, a consultation masterclass, where I’m sort of working with a very small group of clinicians on how to elevate your case presentation and acceptance rates. Other than that, just leaves me to say thank you for your time and attention and hope you got some value out of today. And if you did, please do consider leaving us a review.

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.

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