Month: November 2024

Payman Langroudi: This podcast is brought to you by Mini Smile Makeover. Mini smile makeovers are two [00:00:05] day anterior composite course with Depeche Palmer, who I really believe is one of the top composite [00:00:10] teachers in the world right now. We’ve done this course so many times, we’ve had 2000 dentists [00:00:15] go through it, and the feeling people have at the end of it is not only they can execute on [00:00:20] composite veneers, but they’re just better dentists at the end of it. Have a look. Mini smile makeover.com [00:00:25] for dates. Let’s get to the pod.

[VOICE]: This [00:00:30] is Dental Leaders, the [00:00:35] podcast where you get to go one on one with emerging leaders [00:00:40] in dentistry. Your [00:00:45] hosts Payman Langroudi and Prav Solanki.

Payman Langroudi: It’s [00:00:50] been a great pleasure to welcome Sara Shirvani onto the podcast, [00:00:55] otherwise known as Sara the Hygienist, aka um. Lovely to have you. [00:01:00]

Zara: Thank you. Thank you for having me.

Payman Langroudi: Zahra is a hygienist who’s [00:01:05] really at the sort of cutting edge of the whole guided biofilm biofilm therapy, [00:01:10] um, revolution that that’s happening. Um, someone who [00:01:15] I’ve been talking to a long time about enlighten. And the amount of whitening that she [00:01:20] puts through is really pretty impressive. And I’m interested in, you know, Zahra. Why? You’re [00:01:25] that cat. How come you, um. Some hygienists, when I [00:01:30] talk to them and I say, hey, how about whitening? They just really shy away from it and they don’t [00:01:35] want to have that conversation at all. And then you get the odd hygienist here and there. And our biggest [00:01:40] user, for instance, in the country is the hygienist there. That’s pushing why, [00:01:45] why, why, why are you why are you so calm about it. And everyone else is so worried?

Zara: For [00:01:50] me, I mean, I always want to do more. I [00:01:55] love the gums and I love hygiene. But I didn’t just want to stick to hygiene. I always want to expand my skill [00:02:00] set. Being able to do perio, being able to do whitening, um, is great because why [00:02:05] not? I’m able to do it. I’ve done the training and also to give patients [00:02:10] that confidence in their smile, especially during Covid when everyone was on zoom and they were just looking [00:02:15] at each other. And I feel like patients don’t like the colour of their teeth, but then [00:02:20] they might not want to talk about it. They might not want to say it. So just asking a simple question like, you [00:02:25] know, does the colour of your teeth bother you or anything? Then that gives them the opportunity to open up. [00:02:30]

Payman Langroudi: Yeah, but why do others have a problem? I think like sort of, [00:02:35] you know, Steelman, the argument, look at the other side of the argument and make their case for [00:02:40] them.

Zara: Yeah, I think it can either be a lack of knowledge. So if they haven’t [00:02:45] done the training or they’re not confident or.

[TRANSITION]: Competent, what’s the.

Payman Langroudi: Knowledge? The knowledge that can make your teeth white.

[TRANSITION]: You go on a.

Zara: One day training [00:02:50] course.

[TRANSITION]: Yeah.

Zara: Um, I think it’s also the fear of [00:02:55] within the team. So if the dentist pushes that, you know the whitening should be given [00:03:00] to the dentist and the dentist should be do the whitening, then the hygienist is going to feel inferior, like they shouldn’t [00:03:05] or they can’t. Um, and I think also the complications that can [00:03:10] come from that, they feel like they, they’re not competent enough to deal with it. Um, and [00:03:15] I think the patients itself, sometimes you just get patient expectations and you think that you can’t [00:03:20] manage them. So I think a combination of all those things.

Payman Langroudi: I think look, classically, there’s many dentists don’t talk [00:03:25] about it either. Yeah. And people say I don’t want to embarrass people. I don’t want to offend people. [00:03:30] You know, that whole worry, you know, that the patient is going to feel like you’re telling them they’re ugly [00:03:35] or something. I get all of that. Yeah. That’s I would say that’s a general with whitening. Um, [00:03:40] but how do you get over this financial side of it [00:03:45] in your practices? I mean, if what happens if the dentist has to prescribe it? So [00:03:50] how do you is there an arrangement? Do you talk to the dentist at the beginning and say, I’m going to discuss [00:03:55] whitening with this patient and I’m going to carry it out? Or how do you do it?

Zara: Usually if the patient is a direct [00:04:00] access patient so they come in for their hygiene first they’ll have the hygiene assess the gums and [00:04:05] then they are also interested in whitening. Then I tell them that that’s fine we can do it. Take the shade guide, [00:04:10] give them the consult, and then then say that you need to see the dentist for an exam [00:04:15] just to check that you’re dentally fit. If you’ve got fillings or tooth decay that needs to be addressed, then we need [00:04:20] to do those first. So when I send them to the dentist for the exam, I also just message the dentist, you know, saying, [00:04:25] please, can you see the patient for the exam and send me a prescription if Dental [00:04:30] fit, if they need to do the fillings, I’ll do the fillings first and then I’ll do the whitening. And if not [00:04:35] and it’s all okay, then I’ll do the whitening.

[TRANSITION]: But then does.

Payman Langroudi: It sometimes happen that the dentist wants to do the whitening himself? [00:04:40]

Zara: I have been in situations when it’s been like that, when that’s been the case, [00:04:45] and if the dentist has seen the patient first and had that conversation with the dentist with [00:04:50] the patient, that’s fine because that’s his.

[TRANSITION]: That’s.

Zara: Yeah, that’s his. That’s his or hers. If [00:04:55] they see me first and then they bring it up or they bring it up in the hygiene, then I [00:05:00] can do it. So it works both ways. And you just need to have that mutual respect.

Payman Langroudi: Can’t you. Can’t it [00:05:05] be like a three way financial situation where both the hygienist and [00:05:10] the dentist benefit? I mean, if I, if I was a practice owner, that’s the way [00:05:15] I’d set it up. Yeah. Then you’d be working together. Yeah. To make that happen. And the [00:05:20] principle is what is it, too many mouths to feed.

Zara: It might get a little bit complicated [00:05:25] in terms of who’s actually doing the who’s presenting it to the patient. [00:05:30] And when you’re giving the consult, you’re giving the consult, but you’re also getting the patient on board. [00:05:35] And I feel like that’s that person is that that’s when you’ve [00:05:40] basically you’ve done all the work that’s doing the work, not taking the shade guide.

[TRANSITION]: Yeah.

Zara: So [00:05:45] that person should actually be in.

[TRANSITION]: Because I used to have a.

Payman Langroudi: Canadian hygienist used to work [00:05:50] for us as a salesperson because she was Canadian trained and she was telling me in [00:05:55] Alberta, not not all over Canada, but in Alberta, the the way the setup is, she [00:06:00] said hygienists make more money than associates because they push whitening [00:06:05] so much and fluoride treatments and, you know, for the practice, it’s marvellous [00:06:10] because they can they don’t need the prescription either. They can just go straight in.

[TRANSITION]: Yeah.

Payman Langroudi: Um, [00:06:15] and I think it’s kind of an ignored thing. I mean, like, practices are on to this silly idea, [00:06:20] I think, of trying to sell oral hygiene products to the patient. Like, I don’t [00:06:25] know, what is that? Electric toothbrushes. Yeah. Where the amount of money you can make from those is negligible. [00:06:30] Whereas with the whitening treatment, there could be a six £700 whitening treatment. If you’re going [00:06:35] to spend time talking about something, talk about that.

[TRANSITION]: Absolutely.

Zara: I think also being in the UK, [00:06:40] we’re always, you know, a little bit on the defence or keep calm. We don’t want to rock the boat [00:06:45] and that mentality. Whereas if you actually think about it, there is nothing scary. There’s [00:06:50] nothing scary about it. It’s just having that honest conversation with the patient. And [00:06:55] at the end of the day, as long as you’re ethically selling it, then it’s ethically [00:07:00] justifiable. Whether it’s fluoride, whether it’s whitening, whatever it is, you can justify [00:07:05] that to the patient, to the principal in your notes.

Payman Langroudi: So usually [00:07:10] we start with a backstory. I just had that question. Just a burning question. Let’s [00:07:15] get to that. Where were you born? When did you decide to [00:07:20] do hygiene? Because you did genetics first.

[TRANSITION]: Yes.

Payman Langroudi: Give me give me that story. The what kind [00:07:25] of kid were you?

Zara: So I was born and raised in London, um, fully Iranian [00:07:30] and very proud to be Iranian. I was quite a tomboy growing [00:07:35] up. I was actually the loud, cheeky one, and my sister was the calm [00:07:40] one. And then things kind of switched as we got older. I ended up being the calm one and she [00:07:45] was the cheeky one and I think they’ve switched back again now.

Payman Langroudi: I should say we’ve had your sister on the [00:07:50] Mind Movers podcast. Sana.

Zara: Yeah, yeah.

[TRANSITION]: She’s back.

Payman Langroudi: To that episode.

[TRANSITION]: But [00:07:55] go on.

Zara: And so I where in.

[TRANSITION]: London.

Zara: In [00:08:00] north west London and yeah. So I’ve got a younger sister. Everyone [00:08:05] thinks she’s older, but I’m the eldest. And um, growing up I [00:08:10] loved anything that was creative. So music, drama, all [00:08:15] of that stuff. And then I went into a very academic school where [00:08:20] they didn’t really have any of those things. And obviously, being from [00:08:25] an Iranian background, you had to either be a doctor or engineer or a lawyer and that’s it.

[TRANSITION]: Or failure. [00:08:30]

Zara: Otherwise you’re a failure. Um, which is not right. But [00:08:35] that was how we were raised. And, um, so I basically went to [00:08:40] school, um, and I wasn’t very much academic, [00:08:45] I would say. Um, I just really, really had to put focus and attention. [00:08:50] I always wanted to do different things. Got easily distracted, and I basically [00:08:55] went to university and studied genetics. And I loved genetics. It was actually CSI [00:09:00] that got me into it.

[TRANSITION]: But really? Yeah, it’s not that.

Zara: It’s not as a Swansea University. [00:09:05]

[TRANSITION]: Swansea. Yeah. Yeah.

Zara: So I actually wanted to move outside of London for university [00:09:10] because I did want the full experience.

[TRANSITION]: I was in Cardiff and. Oh, really? Yeah. Oh, nice. Yeah. [00:09:15] Do that. Mumbles mumbles. Yeah, yeah. Joe’s ice cream. Yeah yeah yeah [00:09:20] yeah yeah.

Zara: Um. And then I ended up moving out of the country, so to speak, outside of England. [00:09:25] And I loved all the lab work. Um, and [00:09:30] I actually did a three month internship in Amsterdam, and I was working with the lead professor in chlamydia, [00:09:35] so that was fascinating. Um, but it’s not as as exciting [00:09:40] as what you see on CSI. The reality isn’t. Um.

[TRANSITION]: Never is.

Zara: Yeah. [00:09:45] And then.

Payman Langroudi: You like. Was that. Was that the first time you were away from home?

[TRANSITION]: Um, [00:09:50] I mean, Swansea, not Amsterdam. I mean.

Zara: For that period of time. Yes. [00:09:55] Obviously I did.

[TRANSITION]: Trips and things.

Zara: Like that. I loved it. I mean, I was just like, [00:10:00] this is going to be great. I’m going to be partying all the time. It wasn’t that much of [00:10:05] partying because I went to quite a conservative school. Um, I went to a, [00:10:10] um, Islamic school, a private Islamic school. And then I went to a Church of England [00:10:15] school as well for, for my, um, in sixth form.

[TRANSITION]: So. [00:10:20] But when you got to.

Payman Langroudi: Swansea and you were finally let free.

[TRANSITION]: Yeah.

Payman Langroudi: Did you get a little bit berserk?

Zara: I didn’t I was still [00:10:25] controlled, I would say. Obviously I went out I, you know, [00:10:30] you don’t need to answer to anyone. I came to my dorm whenever I wanted to. Um, I was still [00:10:35] sensible, but I definitely went for it because I wanted that university experience, [00:10:40] and I think that’s the only time in your life when you are carefree and you have that [00:10:45] opportunity, you, you know, you don’t. You go into adulting after that. So that [00:10:50] was great. And, um, I.

[TRANSITION]: Know you were into.

Payman Langroudi: Genetics. Yeah. Into [00:10:55] it enough to go and study in Amsterdam and all that. So why didn’t you become [00:11:00] a continue?

[TRANSITION]: Yeah.

Zara: Because it’s all the lab work I loved. [00:11:05] But a lot of it was research based. So it was just me and a computer, and I was missing people [00:11:10] I loved, you know, speaking to people. I was very much a people person. And [00:11:15] so I basically did a 180 and went into acting. I was part [00:11:20] of the National Youth Theatre and I loved it.

[TRANSITION]: Um, what do your parents.

Payman Langroudi: Think of that?

Zara: They [00:11:25] weren’t as supportive at the time, obviously. Um, but [00:11:30] my mum at the end of it did kind of come around to it and said, [00:11:35] okay, fine. Like, you know.

[TRANSITION]: You know what? Go for it.

Payman Langroudi: What worries me is that [00:11:40] this old thing about doctor, dentist, whatever lawyer. It’s all [00:11:45] well and good on the first generation. I kind of get it. I remember my mum sitting [00:11:50] me down and saying, look, we had a revolution. And the only people who managed to do [00:11:55] well after that were the doctors and dentists. So that’s why it should become a dentist. I remember that conversation. [00:12:00] And so, you know, first generation trauma. Yeah, but it would be a goddamn shame [00:12:05] if the next generation, like your kid, if you then projected the same [00:12:10] thing onto your kid. It’d be a bit of a shame. And, you know, if we all do that, if we all constantly [00:12:15] project that to our kids, there will be no movies, there’ll be no music, there’ll be no plays [00:12:20] here. On the other hand, my kids are at that stage now. Yeah they [00:12:25] are. My oldest is about to go to university, and you strangely find yourself [00:12:30] giving that same advice.

Zara: Um, what does he want to study?

Payman Langroudi: Aerospace engineering. [00:12:35] He’s saying. You know, but but it’s a weird thing because, you know, you know, that classic thing. Oh, [00:12:40] let them do what they like. Yeah. The reality is, the vast majority of kids don’t know what [00:12:45] they like. That’s true. Yeah. And so my kids, what do you want to be? I don’t know. Um, [00:12:50] my daughter right now is 14. I have no idea. Yeah. So then they kind of. They [00:12:55] kind of looking to you for advice and then advice wise, you kind of say, oh, well, I don’t know, become [00:13:00] a professional of some sort, make some sort of sense. Yeah. And so, you know, we’ll never [00:13:05] end up with the filmmakers.

Zara: I totally agree with that. Coming from [00:13:10] a parent parents point of view, because you want to know that your child’s going to be stable, have a future, be [00:13:15] able to stand on their own two feet, I think also. Yeah, if we keep doing that, then generation [00:13:20] isn’t going to change. And instead of improving, we’re just going to stay the same or even get worse. [00:13:25] So I think there needs to be a balance between, you know, go out, experience [00:13:30] life, take the gap year, you know, travel, Try different things. See what it is [00:13:35] that you like. You know, go into shadowing a few different areas.

[TRANSITION]: And see what you.

Zara: Like. Exactly. [00:13:40] Taste stuff. Because if you don’t taste it, you’re never going to know. Um, but at the same time, I think [00:13:45] completely leaving it down to a teenager child [00:13:50] at that time. You’re right. We don’t know what we want. We’re told to grow up, go to school, go to university, get married, have [00:13:55] kids. That’s your life. And it doesn’t work that way. Um, I think it can go the other way as well. If you [00:14:00] completely let the child go, which isn’t right. So I think you still need to be there in the background giving advice. [00:14:05] But you should also let the child choose first, and then you can, [00:14:10] you know.

Payman Langroudi: But if your parents were fully behind you being an actress, do you think, like you [00:14:15] would have gone that direction?

Zara: Yeah, I think having a bit more support would have made me feel like, [00:14:20] yes, I can do it. And I didn’t feel that.

Payman Langroudi: Mm.

[TRANSITION]: So then how [00:14:25] did why hygiene.

Zara: So I, so the reason [00:14:30] that I left was that only obviously 1% you know of actors actresses [00:14:35] become can work. Otherwise you’re living from job to job. So I needed that security. [00:14:40] And my mum said she was in the industry and she said.

[TRANSITION]: In the Dental. [00:14:45]

Zara: In the Dental industry.

[TRANSITION]: Yeah. What was she doing?

Zara: She was a, she was she started off as a dental [00:14:50] nurse and then was a practice manager for 20 years. Then she did a general nursing, studied [00:14:55] that, and now she’s an aesthetic practitioner. So she’s just my Wonder Woman. [00:15:00] Um, and I went to, um. [00:15:05] Yeah. She said that it’s really competitive. Why don’t you try dental hygiene? And she basically [00:15:10] had a hygienist who was working in the same practice at the time and was still friends now. I went to shadow her and [00:15:15] I was like, oh, wow, this looks so satisfying. Just seeing her like, take off that couch.

[TRANSITION]: Do you not consider dentistry? [00:15:20]

Zara: Not at the time, no.

[TRANSITION]: Why the extra five years? Yes. [00:15:25]

Zara: Yeah. I was like, I’ve already done a degree. I don’t want to do another. No.

[TRANSITION]: And become [00:15:30] a.

Payman Langroudi: Dentist, right? By now, you’d be like a four year qualified dentist.

[TRANSITION]: Oh, I get it.

Zara: All the time. Don’t you want to do dentistry? Don’t want [00:15:35] to do therapy? No, because I absolutely love the gums. [00:15:40]

[TRANSITION]: Oh, really?

Zara: Don’t care about teeth. If I could be a periodontist [00:15:45] without being a dentist, I’d do it. I love the gums. They’re the foundation that hold everything [00:15:50] together without the gums. You got nothing.

Payman Langroudi: Fair enough.

Zara: Um.

[TRANSITION]: So [00:15:55] then. Yeah, I went and studied hygiene. Yeah.

Payman Langroudi: Yeah. And applied.

Zara: I applied, my mom [00:16:00] was like, you know, it’s really competitive.

[TRANSITION]: Super hard to get in. Yeah.

Zara: Really competitive. But especially in London. I miss the Queen Mary [00:16:05] deadline by one day. And then I applied to the Eastman. It was the only place that [00:16:10] I had applied to. And my mum said, yeah, it’s competitive. You might have to do dental nursing beforehand. [00:16:15] And I was like, oh my God, no. Um, and then I went there and then I remember [00:16:20] the interview day, there was a girl there, and she was like, I’ve been trying for seven years. I was like, oh my God, I’m not going to get this. Like, [00:16:25] I’m not. I wasn’t even a dental nurse. And so I got in [00:16:30] my first try, and it was me and another girl on the course and who weren’t dental [00:16:35] nurses. And then after that it was, well, it wasn’t all [00:16:40] easy. I remember the first mock exam that we had.

[TRANSITION]: It’s a difficult course.

Zara: Yeah, especially because [00:16:45] it’s shorter. Course. You get thrown in, you get thrown into clinic a lot quicker. Uh, seeing [00:16:50] patients sooner as well than, you know, doing dentistry. And I failed my [00:16:55] mock first year. And then that was a bit of a wake up call. [00:17:00] Like, I can’t actually keep doing the same thing I was doing at university. This is like, you know, real. It was [00:17:05] more of a pressurised course as well. So it was shorter, but it was pressurised. And, um, that was a [00:17:10] wake up call. After that, I really, really put my head down and then. Yeah, passed.

[TRANSITION]: And did you like. [00:17:15]

Payman Langroudi: When you were at the Eastman, did you feel the weight of being at the Eastman? I mean.

[TRANSITION]: Yes, there’s. [00:17:20]

Payman Langroudi: An atmosphere at.

[TRANSITION]: The Eastman.

Payman Langroudi: Yeah, excellent. Sort of famous people, people who’ve written books [00:17:25] and things walking around.

Zara: Yeah, at the beginning, I didn’t know. I had.

[TRANSITION]: No idea.

Zara: And then I read it and I was [00:17:30] like, oh, this is like the rod of or like the Harvard of, you know, uh, dental school. [00:17:35] I was like, oh, wow. And I was like, oh, that’s nice. Yeah. But it was it was very pressurised. You know, it’s lectures [00:17:40] in the day clinic in the afternoon, and I was in the library until 10:00 pm at night, [00:17:45] um, you know, shorter holidays. And I think because of that, it felt like a [00:17:50] little bit like boarding school. It was that very old mentality, which I’m grateful [00:17:55] for. It got me to where I am today, but it was difficult.

Payman Langroudi: So which year was that? That you qualified? [00:18:00]

Zara: 2000? 18? 19? 19? Yeah.

[TRANSITION]: Just before [00:18:05] Covid. Yeah. Um hum. Yeah.

Zara: Thank God, because I absolutely [00:18:10] hate online learning. I need to be in that lecture theatre. I don’t know how how everyone else [00:18:15] did it during Covid.

Payman Langroudi: Are you a bit ADHD?

Zara: I don’t know.

[TRANSITION]: Like [00:18:20] I’ve never been tested. I don’t mean that, but.

Payman Langroudi: You’re.

[TRANSITION]: Like attention span.

Zara: Yeah, I need to, you know, [00:18:25] in the classroom when, you know, the lecturers there got, you know, I need to be. It’s physical. [00:18:30] I can’t do it online.

Payman Langroudi: So I’m really interested. A lot of hygienists work in a lot of different [00:18:35] practices. And it’s kind of a weird thing because. Why? Why that why? I mean, if [00:18:40] you work in for five days a week in different practices, you could be working in one practice for. [00:18:45]

Zara: I actually did try that when I first qualified. I was full time, I think 4 or 5 days in one [00:18:50] place.

[TRANSITION]: Yeah.

Zara: And I didn’t like it. It wasn’t for me.

Payman Langroudi: So you like the fact that you’re in different places?

[TRANSITION]: Yeah, [00:18:55] I.

Zara: Do like it. I mean, it works for some people, which is great, but for me, I love the variety going to different [00:19:00] locations, different cohorts of patients. Um, that’s what works for me.

Payman Langroudi: All [00:19:05] right. So. So if you had to tot it up, how many practices have you worked [00:19:10] in in total around?

Zara: Um, I would probably say maybe [00:19:15] about seven, eight, maybe [00:19:20] nine, something like that over the years. Yeah, I was at five practices at once [00:19:25] in one at one time, but it was very, very difficult. And then I cut down to four [00:19:30] and I’ve cut down to three and just increased my days.

Payman Langroudi: So I’m super interested in this question of, [00:19:35] you know, you’ve seen the way that lots of different practices operate. And [00:19:40] Hygiene’s role is a funny one, because often they’re not even considered as member [00:19:45] of staff because they’re only in one day a week. They’re not. Like, for instance, do you get invited to a Christmas [00:19:50] party? Not always.

[TRANSITION]: No. Yeah, of course I do. Do you do we are.

Zara: We are the foundation [00:19:55] of the team.

[TRANSITION]: Well, that should be right. Yeah, it should be.

Payman Langroudi: But what I’m saying.

[TRANSITION]: Is, if. [00:20:00]

Payman Langroudi: You’re only there one day a week, you’re not part of the team in the same way as someone’s there full time. [00:20:05]

Zara: I think it’s changing because we are [00:20:10] we are heavily relied on in terms of patients oral health. If patients [00:20:15] got gum disease, if they’ve got gingivitis and bleeding, you can’t put the veneers on. They can’t have full [00:20:20] composite veneers they can’t like your hygiene needs to be good, otherwise the implant is going to fail. You [00:20:25] know the dentist is going to fail. All these things so it all interlinks. Hygiene is a huge, huge [00:20:30] aspect and it’s actually what you’re doing, you know. So I will offer to help or, you know, do this [00:20:35] or do that to you are part of the team. At the end of the day, even if you are going in once or twice [00:20:40] a week into that practice.

Payman Langroudi: All right. So for instance, right now you’re [00:20:45] at the health society. Yes. Victoria was just on diary of a CEO. [00:20:50]

[TRANSITION]: Yes.

Payman Langroudi: Um, that’s a different practice, right? That’s a very hygiene led practice.

[TRANSITION]: Yeah, which [00:20:55] I love. It’s great. It’s a.

Payman Langroudi: Brilliant practice. It looks different. It feels.

[TRANSITION]: Different. It is different. [00:21:00]

Payman Langroudi: It is different that a practice. I’ve really enjoyed going there. Um, you’re at Thurlow Street?

[TRANSITION]: Yes, [00:21:05] which I’m.

Payman Langroudi: Good friends with them for years. They were one of my original enlightened users. Years and years and years [00:21:10] and years ago. Yeah. And then doctor. Mr.. She doesn’t like that. Drmr. [00:21:15] Yes. Marina.

[TRANSITION]: Yeah.

Payman Langroudi: Another totally different angle.

[TRANSITION]: Exactly.

Payman Langroudi: He [00:21:20] sought high profile patients. Yes. So, of course you’ve been [00:21:25] in those, but you’ve been in the other 6 or 7 as well. What lessons have you learned from [00:21:30] the way people run their businesses? Yeah. And, you know, you’d imagine [00:21:35] from the outside you’d imagine a dental practice or a dental practice, but all of us who’ve worked in dental practices know that that’s [00:21:40] not the case. They’re very different to each other. And I haven’t worked in that many. I’ve worked in maybe [00:21:45] five in total before I started this. And I found the thing that was the worst [00:21:50] in a dental practice was when there’s two teams. There’s like power [00:21:55] bases, two different power bases working against each.

[TRANSITION]: Other within the same practice.

Payman Langroudi: Yeah. [00:22:00] Yeah. And I’m talking about amongst the staff. Yeah. You might have the manager and [00:22:05] three people and then, I don’t know, the lead nurse and four people in [00:22:10] two separate teams. Have you ever come across that? I have.

Zara: I haven’t, maybe [00:22:15] more so with staff like the. [00:22:20]

[TRANSITION]: But you’re not there long enough. You’re not there long.

Payman Langroudi: Enough to really see it.

Zara: I [00:22:25] saw it in the one practice that I was in full time.

[TRANSITION]: Oh, really?

Zara: Which I didn’t like. And that’s why [00:22:30] I decided it wasn’t for me. And so I much prefer going into, like, different places.

Payman Langroudi: Like, sometimes it’s [00:22:35] an incompetent manager.

[TRANSITION]: Yeah.

Payman Langroudi: Like, that’s the reason why the head nurse [00:22:40] is on this other side, constantly talking about the incompetence and then the teams [00:22:45] break out into I’m sure people listening to this all have they can there’s echoes [00:22:50] of what’s going on in their own practices.

[TRANSITION]: I don’t think that it doesn’t happen in every practice. But it [00:22:55] does happen.

Zara: It does happen. And I now that you’ve mentioned it, yes, I [00:23:00] have experienced it, but it’s not. There shouldn’t be a hierarchy. Everyone is the same, but also that sort of like [00:23:05] ego coming into it. Or you know that I’m better there. It shouldn’t be like that at [00:23:10] all. The job is already stressful as it is. But you know, we don’t need to sit and talk [00:23:15] or gossip. We just want to get on with our job. Um, yeah.

Payman Langroudi: But then you must have come across a [00:23:20] dentist who thinks they’re better than you and.

[TRANSITION]: Orders you around.

Payman Langroudi: Or. That must have happened, right?

Zara: Yeah, [00:23:25] it. Sadly, that is. It does happen. Um.

[TRANSITION]: And [00:23:30] the opposite.

Payman Langroudi: Right. The other, the very enlightened dentist who’s, like, totally sees you as as a as [00:23:35] an equal.

[TRANSITION]: As a. Yeah.

Zara: And you’re always going to be drawn to those people because there’s, they see [00:23:40] you at the same level. I always feel that you can learn something from everyone. I can learn from my dental [00:23:45] nurses. I can learn from my dentist, from a from a manager, from a TCO, whatever [00:23:50] it is, everyone can learn from each other. And I’m never I never get to that point where I’m like, okay, yeah, I know everything [00:23:55] now. You will constantly be learning through life.

[TRANSITION]: I mean.

Payman Langroudi: Where I learned the most about [00:24:00] a hygienist lot was there’s a group on Facebook. Mhm. I can’t remember [00:24:05] what it’s called now, but hygienist whatever. And some of the stories, some [00:24:10] of the stories about the way people are treated on those on that group, and I know what I mean. I get it, [00:24:15] it’s like a place where people come to vent, you know? But, you know, anytime, you know, there’s [00:24:20] this whole debate about women in dentistry, not enough lecturers or women and all that. And [00:24:25] I often think about, you know, the practices are full of women, right? Whether it’s managers, [00:24:30] nurses, hygienists, therapists that crowd often gets [00:24:35] a bad deal from from dentists.

[TRANSITION]: Yeah.

Payman Langroudi: And some of the things [00:24:40] I can’t remember now, but some of the things people say. So go.

[TRANSITION]: On.

Zara: I remember because [00:24:45] when I first qualified, that’s the first support network that I heard [00:24:50] of.

[TRANSITION]: Oh, really?

Zara: Yeah. So, um, I was part of it, and I could read the things that people [00:24:55] were saying, and it scared me. I just thought I’d. I’ve just qualified. [00:25:00] Of course I’m going to have questions. I feel like I can’t reach out. Um, I [00:25:05] did post a few times anonymously because of that reason. Because I was. Yeah, I was scared about [00:25:10] what people would say, even if I wasn’t in the wrong, or if I were just reaching out for advice. And I feel [00:25:15] like we’re all in the same boat. We should be helping each other. Why should there be a quick judgement [00:25:20] on other people who are asking a question? You don’t know the full story.

Payman Langroudi: Have [00:25:25] you ever had any sort of.

[TRANSITION]: I don’t go.

Zara: On there anymore?

Payman Langroudi: No. Have you ever [00:25:30] had ambitions of like sort of, I don’t know, BSD, you know, getting getting [00:25:35] involved?

Zara: Um, yes. But also I [00:25:40] think it just depends on what direction you want to go into. If you really want to go into sort of [00:25:45] teaching side of it, or if you want to go into a different direction, [00:25:50] I mean, having a lot. On being at five different practices. I didn’t really have the time. So now [00:25:55] that I kind of cut back, I can assess and I’m in a position to then like now be able to pick [00:26:00] and choose, you know, what other extracurriculars that I want to do.

Payman Langroudi: Okay, let’s get on to I [00:26:05] really want to get on to GPT T guided by a film [00:26:10] therapy. And because I’m going to be upfront to you about this here, I think M’s [00:26:15] are masterstroke, absolute masterstroke for coming out with this idea. [00:26:20] Yeah, that’s caught on so well. And to me, correct me [00:26:25] if I’m wrong, I feel like they’ve named something like they’ve given it a name [00:26:30] that was already happening. But then when I talk to people that people are really, [00:26:35] really evangelical about it, like people adore it, like people bang on about it. So [00:26:40] just just set it out for me, man. What is it?

Zara: So, um, I’m [00:26:45] an ambassador for GT, and the reason that I got into it is because [00:26:50] I basically tried it and loved it, [00:26:55] but.

[TRANSITION]: What is it?

Zara: So it’s a combination of warm water. Water is heated to 40 degrees [00:27:00] every time you go for your hygiene. Patients are like, oh, it was sensitive.

[TRANSITION]: Warm water comes out of the scaler.

Zara: Yeah, [00:27:05] it warms it up. Okay, now.

[TRANSITION]: You could.

Zara: Argue that. Oh, I’ll just pour warm water into the bottle. [00:27:10]

[TRANSITION]: Okay.

Zara: It’s winter. You just wait five, ten minutes. By the time you’ve done medical history, [00:27:15] that water is going to be cold.

[TRANSITION]: Okay.

Zara: Um, erythritol powder. So it’s [00:27:20] a naturally occurring antimicrobial powder. You can use it on veneers. It doesn’t.

[TRANSITION]: Scratch. Also comes [00:27:25] out of the skin.

Zara: Yeah, exactly. Um. The tongue, soft tissue. It doesn’t doesn’t harm anything [00:27:30] at all. Gets rid of all of that biofilm, the harmful bacteria and air. So it’s like an antimicrobial [00:27:35] spa for the mouth.

[TRANSITION]: But is.

Payman Langroudi: It is it does it also remove.

[TRANSITION]: Stain?

Zara: Yeah, it removes stain. [00:27:40] It removes the biofilm. It polishes all in one.

[TRANSITION]: Oh, okay.

Payman Langroudi: So so it’s basically. [00:27:45]

[TRANSITION]: Like a super.

Payman Langroudi: Duper scaler.

Zara: It’s it’s even better because that powder will [00:27:50] continue to work throughout the day so that patient’s oral hygiene is going to improve every time [00:27:55] they come back. It’s improved. When you’re doing the pocket chart, you can see it’s improved greatly. [00:28:00] Yeah.

[TRANSITION]: All right.

Payman Langroudi: So so okay that’s the machine. Yeah.

[TRANSITION]: What else? Where’s [00:28:05] the guided part?

Zara: The guided part is from the disclosing the purple dye that we we placed on. So it’s [00:28:10] a purple vegetable dye. Yeah. And that’s the most important part for me because it’s an [00:28:15] extremely educational tool for that patient to see what’s going on in their mouth. If you don’t apply that, [00:28:20] you can’t.

[TRANSITION]: Disclose anyway, don’t you?

Zara: Yes, I have heard you can just disclose, but without that air flow, if you [00:28:25] are going to get the disclosing off with an ultrasonic scaler, you will be there for two [00:28:30] hours and it’s never going to get all of it. How are you going to take that off the gum? Use the ultrasonic scaler on the gum. [00:28:35] You can’t to then demonstrate to the patient that the biofilm covers everything, [00:28:40] even on the tongue. So you need that. And it’s also about that comfort. It’s [00:28:45] more of a comfortable treatment. It’s more gentle. It’s more efficient. Um, it’s what’s not to love. I [00:28:50] have really thought about cons, and I can’t think of any. You end up making the money back as a business [00:28:55] because word of mouth, you know, that’s the only treatment.

[TRANSITION]: Is it? Much more comfortable?

Zara: It’s way more comfortable. [00:29:00] The pressure is gentle. It’s not like the older airflow systems where it would splatter [00:29:05] all over your face, over your glasses. Just feel like you’re going through a car wash because it’s so [00:29:10] high pressured patients, you know, say, oh, I fell asleep in the chair. It was so [00:29:15] comfortable and never had this. They guaranteed to come back. What’s not to love yet?

Payman Langroudi: That in [00:29:20] itself, if you’re telling me, look, I’ve never used it, but if you’re telling me, come.

Zara: And see me and then you’ll.

[TRANSITION]: See. [00:29:25] Yeah.

Payman Langroudi: If you’re telling me it’s more comfortable, that in itself is enough. Yeah, because hygiene is uncomfortable, [00:29:30] man.

Zara: The amount of patients that come to me like, oh, I’ve had such a bad hygiene experience, it was so [00:29:35] painful. Hygiene does not need to be painful. It should be gentle, thorough. It does [00:29:40] not need to be painful. One bad experience. It will put you off for life. You’re never going to come back [00:29:45] now. Do you want the patient to come back or not come back?

Payman Langroudi: But there’s another aspect to it though. Yeah, that like [00:29:50] in a way, if it’s not uncomfortable, you feel like you’re not getting deep enough. [00:29:55]

[TRANSITION]: Do you know what I mean? Yeah. You know what I mean.

Payman Langroudi: You want to you want to you want to get into Dental. You want to get [00:30:00] subgingival?

[TRANSITION]: Yeah. You can’t get subgingival a bit.

Payman Langroudi: You know, like.

[TRANSITION]: If.

Payman Langroudi: Because if you’re going [00:30:05] to get subgingival.

Zara: So that’s just the airflow part of it. Yeah. Then there’s the person. So [00:30:10] it’s, um, the the way it works laterally, it’s not painful [00:30:15] at all. So it’s no pain scaler basically because of the technology [00:30:20] behind it. So you can remove the.

[TRANSITION]: Airflow.

Payman Langroudi: Incorporated in the scaler or is it.

[TRANSITION]: Two separate. It’s two. [00:30:25]

Zara: Separate. So you use the airflow first. So it’s more of a minimally invasive. Yeah. Um [00:30:30] way. So you use the airflow to remove the bacteria biofilm polish everything like that. And then the [00:30:35] scaler is just for any hardened bits of calculus, whereas before it was the opposite. You’d use a scaler everywhere and [00:30:40] then do the polishing, which still wouldn’t get rid of 100% of that biofilm the way [00:30:45] the GT protocol does. So that scaler will just get rid of any of the harder calculus. [00:30:50]

[TRANSITION]: And then are you.

Payman Langroudi: Selling that as an add on? [00:30:55] Like, I mean, when someone comes to one of these practices, do they all have.

[TRANSITION]: It, by the way?

Zara: They all have.

[TRANSITION]: It. All right, so when.

Payman Langroudi: Someone [00:31:00] comes to one of these practices, is there like a basic scale and an advanced and the advanced is the [00:31:05] is the guided biofilm therapy or is it standard.

[TRANSITION]: That’s the standard one.

Zara: No, that’s a standard. So I use it [00:31:10] in two of my practices. Um, and it’s, it’s standard because [00:31:15] once you give the patient a choice and then they see the fee difference, they’re [00:31:20] going to go for that thinking, okay, it’s fine, I’ll just go for that. But they don’t know the benefits that they’re going to get from the treatment, [00:31:25] the powder. How improve the gum health is going to be once they have that [00:31:30] they don’t go back. And I’ve had patients who would try it and they don’t go back to the old way.

Payman Langroudi: But [00:31:35] then but then how do you make your money? You increase the price of a scale and polish.

Zara: For the GT. [00:31:40] You increase it. Yeah, because it’s a more enhanced treatment.

Payman Langroudi: Yeah, yeah. But that’s [00:31:45] what you do. You just say, yeah, it’s more expensive because.

Zara: No we don’t I don’t [00:31:50] call it scale and polish. It’s so much more than that.

[TRANSITION]: Sure.

Zara: Hate that word.

[TRANSITION]: Don’t use it.

Payman Langroudi: Really? [00:31:55]

[TRANSITION]: Yeah.

Zara: Because we’re more because then, you know, the hygienist is just a cleaner. No. [00:32:00] You know, it’s so much more. You’re linking them out to the rest of the body. The link between gum disease [00:32:05] and systemic health, diabetes.

[TRANSITION]: And it’s nothing to do with GPT three.

Zara: It is. [00:32:10]

[TRANSITION]: Why?

Zara: Because with that, you’re removing that biofilm. That biofilm is that harmful bacteria [00:32:15] that’s leading to all these other systemic diseases.

[TRANSITION]: Yeah.

Payman Langroudi: But listen, man, you. [00:32:20]

[TRANSITION]: Still cannot get rid of.

Zara: 100% of that bacteria.

[TRANSITION]: Using just.

Zara: An ultrasonic scaler. I guarantee. [00:32:25]

[TRANSITION]: It.

Payman Langroudi: No ultrasonic and an air flow even with.

Zara: Yeah, but is that going to be comfortable [00:32:30] for the patient where it’s like, you know, hitting their gum, the gums bleeding, it’s going all over the [00:32:35] glass. It’s going all over the face. Going all over you. It just depends on [00:32:40] what kind of treatment you want to provide.

Payman Langroudi: I was a massive cynic when I first saw it. Massive. [00:32:45] And I just. I just take my hat off to that. I was thinking wonderful marketing and but [00:32:50] I have to say, every single person I’ve asked who uses it adores it, Like loves it. [00:32:55] And so that’s a good sign.

[TRANSITION]: Yeah, because it.

Payman Langroudi: Pretty much says it all.

[TRANSITION]: It’s bloody.

Zara: Brilliant. [00:33:00]

Payman Langroudi: How much does it cost?

Zara: The machine or the treatment machine? Um, [00:33:05] the machine I think is about around ten K. I want to say [00:33:10] something like that, but you would be surprised how quickly.

[TRANSITION]: You make that money off to them. [00:33:15]

Payman Langroudi: Well done.

[TRANSITION]: Ten k, let me.

Zara: Tell you this. I’ve managed to get, I [00:33:20] think, over the time span that I’ve been working, I think I’ve gotten six [00:33:25] of my practices to get the machine and they love it. At the beginning [00:33:30] it was like, oh, you know, it’s really expensive, blah blah, blah blah. But when they see how [00:33:35] increased revenue that that machine brings and you’re going to be using that on every [00:33:40] single patient, every single patient is then going to go and tell their family and friends that, oh, I want this new treatment, the biofilm, [00:33:45] go to biofilm therapy. You’re going to make that money up easy.

Payman Langroudi: I mean, look, I [00:33:50] remember I’ve never owned a practice, but in practice that I’ve worked people, [00:33:55] um. Interviewing hygienists. And I remember thinking, I used to. I [00:34:00] used to ask to. Be in those interviews. And I remember thinking when they’re doing the interview. [00:34:05] I remember thinking, none of this matters. It’s how. It’s how they actually do the. Work that matters both [00:34:10] in terms of, you know, are they thorough enough and. Are they gentle enough? And I used to always worry [00:34:15] about that, that tension between. Being thorough enough and gentle enough. Because to me, [00:34:20] if you’re thorough. Enough. You’re not that gentle. You have to go a bit deep. Now, if the machine and the training. [00:34:25] Addresses that problem. If it does, yeah, because I don’t know, you might [00:34:30] be super. Super gentle hygienist anyway. Yeah. And the next person is going to hurt the person with. The [00:34:35] you know GPT as well. Yeah. But if it does then it’s well worth it because you [00:34:40] know. The number of mistakes people make in hiring a hygienist. And then patients come in and say. Oh, we all loved [00:34:45] the other one. And this one’s not not gentle. And you know that ten grand is. Well worth paying [00:34:50] the money for you. Yeah, he concludes the advert for EMS.

[TRANSITION]: You need [00:34:55] both. You need.

Zara: Both of those.

[TRANSITION]: Things. Yeah.

Zara: Gentle and technique.

Payman Langroudi: Tell me [00:35:00] about. You know, you were saying. And you’re right. The hygiene department gets involved in every [00:35:05] single other department of a practice. Insomuch as if I’m putting implants in, everything [00:35:10] needs to be tipped off. Um. With implants. Are you treating much peri [00:35:15] implantitis?

Zara: Yes. Um, obviously, once you’ve got bleeding [00:35:20] around the implant, then the percentage of it failing is a lot higher. And [00:35:25] so it’s so, so important. Again, that’s where the guided biofilm therapy comes into action, because I can [00:35:30] really get up there, um, with the instruments, with my airflow and then remove all of that harmful bacteria. [00:35:35] And nowadays, I mean, you know, who doesn’t have implants? It’s a very common dental [00:35:40] treatment. And the patient needs to be dentally fit, need to have good bone level, [00:35:45] um, before they end up having the implant. And then after that implant, like the Ferrari of [00:35:50] teeth, they need more maintenance. You know, you can’t just be coming in every 6 to 9 months. [00:35:55]

Payman Langroudi: So what is the difference between treating pre implantitis and periodontitis? [00:36:00] Like are they different.

[TRANSITION]: Instruments that use.

Payman Langroudi: Different plastic instruments.

Zara: No [00:36:05] I’m not a fan of the plastic ones. But also their home care is really important. So what they’re getting up around [00:36:10] those areas. Um the single tufted brush super important for them to [00:36:15] use. If there is bleeding, you know, I’ll ask them to put some ginger gel on there and then work that [00:36:20] that gel into into the gum margin. Um, so it’s a combination of their home care and [00:36:25] then the hygiene appointment as well.

Payman Langroudi: Enough.

Payman Langroudi: For [00:36:30] hygiene. I noticed you went to Iran recently.

Zara: Yeah I [00:36:35] did.

Payman Langroudi: And I noticed you going around seeing all the sites.

[TRANSITION]: Yes.

Payman Langroudi: Had you not [00:36:40] done that before? Is it a new.

[TRANSITION]: Thing for you?

Zara: Yeah, it is a new thing. I usually would just go [00:36:45] back to Tehran, which is the capital. My family lived there originally. My both [00:36:50] my mom and dad are from Tabriz, the north of Iran, but that’s where we would just go to to [00:36:55] the capital. But this time I actually got to go to different areas. My uncle lives in Bandarabbas, [00:37:00] which is the south. Um, and it when I was posting photos, everyone [00:37:05] was like, oh, are you in Mexico? I was like, no, I’m in Iran. And it’s just they don’t know what it looks [00:37:10] like. Um, this year I also went to Esfahan as well. Um, so many world [00:37:15] Unesco heritage sites. There’s so much history and culture. Um, and that [00:37:20] side of things is never shown on the media. It’s always a negative news. And people [00:37:25] think of Iran and they think of just, I don’t know, an Arab country in the Middle East. And it’s not we don’t speak [00:37:30] the same language. Um, Iran is the oldest country in the world, and I’m passionate [00:37:35] about it. So I like to show that and showcase it because the Western media [00:37:40] isn’t doing it. And whenever I do, I always get messages like, wow, it looks amazing. I really want to go [00:37:45] and it’s a very positive thing. We’ve got great food, really hospitable people, [00:37:50] uh, all full seasons. Just it’s anyone who’s [00:37:55] been there is like, I loved it.

[TRANSITION]: But do you.

Payman Langroudi: Feel Iranian?

Zara: I do.

[TRANSITION]: Yeah. [00:38:00] Do you feel British? Yes.

Zara: Even though I was born and raised here, I never say [00:38:05] I’m English. I always say I’m Iranian. I am British citizen, but ethnically, [00:38:10] I’m Iranian. I never get cold. Called a British, an English rose. [00:38:15]

[TRANSITION]: I get everything else except English rose.

Zara: I’m not blue eyed and [00:38:20] blonde and that’s fine.

Payman Langroudi: I think living in London, you sort of end up keeping [00:38:25] your identity a little bit. But I’ve got cousins in America.

[TRANSITION]: Yeah.

Payman Langroudi: Who within [00:38:30] months they’re USA, you know, like some of the culture [00:38:35] there because maybe because the country is made up of immigrants, the culture, [00:38:40] their people assimilate like they they become it very quickly. [00:38:45] And yet you were born here and you’re saying I’m a proud Iranian?

[TRANSITION]: Yeah.

Zara: I [00:38:50] think it’s just knowing that again, it’s what the media shows, which is negative. [00:38:55] And then so they might feel like they don’t want to be associated with that. Let’s [00:39:00] do the opposite. Oh, America. Freedom. It’s a better country. It’s not always the case. [00:39:05] Actually, Iran has a lot to offer, and it’s just maybe it’s concealed and it needs [00:39:10] to come out. Um, you know, they’ve always got tour guides. Whenever someone speaks to me about it, [00:39:15] I’m like, just get yourself on a tour. You need to take two weeks off. They’ll take you around. They’ll [00:39:20] book everything. You just need to show up. It. There’s so much. But it’s that mindset [00:39:25] of, do I just listen to what the media is showing? Or do I do my own research and find out what’s what [00:39:30] it’s actually like?

Payman Langroudi: Yeah, no, but it’s interesting that you want to keep going back. [00:39:35] I mean, you could each of these holidays, you could go to Thailand. You could go to Australia.

[TRANSITION]: Oh, no, that’s. [00:39:40]

Zara: Still on the list. Payman.

[TRANSITION]: I promise you, it’s still on the list.

Zara: Just need to find the time.

[TRANSITION]: But, you [00:39:45] know.

Payman Langroudi: It’s drawing you back, right? Yeah. And what would you say that is? Is that because [00:39:50] of friends and family, or is it there’s something in you that trying to get back to your roots or something?

Zara: Um, [00:39:55] I think I just love exploring. I love travelling and seeing different [00:40:00] parts, especially from places where I am from. I feel like I want to learn more. And, [00:40:05] uh, this time around, we basically went with a group of friends who [00:40:10] knew the area. Obviously they’re from there. And so they took us around and explained [00:40:15] everything. And it’s nice to find, you know, depending on where someone is from, then they can show you around. [00:40:20] It’s like if someone came to London, I know I live here, I was born here, I can take them around. Um, but [00:40:25] at the same time, I still think seeing and exploring other countries is still as important. [00:40:30] That life experience of travelling. You learn so much whether you go with a group, whether you [00:40:35] go with a partner, whether you go solo, um, you learn so much and it’s so important because [00:40:40] it’s just like if you don’t within your means, obviously, you know, you don’t need to be going to Mauritius [00:40:45] every month. It’s like a reading one page of a book. [00:40:50]

[TRANSITION]: You go solo sometimes I.

Zara: Do, yeah. And I think, yeah, I’m not I’m [00:40:55] not someone who’s scared or frightened of doing things on my own. I don’t let it stop me. There [00:41:00] is always a little bit of anxiety beforehand, but I’m like, it’s okay, it’s going to be fine. You’ve done [00:41:05] this a hundred times. You like, I’ll take a book. I’ll see whatever. Like other social activities that are going [00:41:10] on. I’m. Yeah, I think it’s really important to be okay to be on your own.

Payman Langroudi: I love being by myself. Do [00:41:15] you ever go to a restaurant by.

[TRANSITION]: Yourself.

Zara: In London? Not so much. But when I’m abroad and I’m travelling [00:41:20] on my own, then.

[TRANSITION]: Yes, but why.

Payman Langroudi: Not in London?

Zara: I don’t know, because there’s always people. So you’ll be like, oh, [00:41:25] you know, you call up your friends, you’ll be like, oh, do you want to go for dinner? Do you want to do this? And it’s more of a social thing to catch [00:41:30] up with people.

Payman Langroudi: No, but you’ve got no anxiety about it.

Zara: Um, [00:41:35] no, actually, I have had lunch on my own a few times, just like in a restaurant.

[TRANSITION]: But no. [00:41:40]

Zara: I haven’t. No.

[TRANSITION]: Let’s go through that anxiety.

Payman Langroudi: Why is there anxiety around that?

[TRANSITION]: Do you know why? [00:41:45]

Zara: I think it’s just being on your own. And that’s why people the first thing they pick up is their phone. [00:41:50]

[TRANSITION]: Yeah. And like, you know, when.

Zara: You’re on your own, you’re just checking that. But sometimes that’s why [00:41:55] I’ll take a book just to be okay with not having to feel like.

[TRANSITION]: I need to check.

Payman Langroudi: I need [00:42:00] the headphones. Yeah. For instance, if I go by myself. Yeah, but but you know, this question [00:42:05] of being, I don’t know, single or someone said to me, yeah, I [00:42:10] feel like people are looking at me and thinking she’s been stood up.

[TRANSITION]: Mhm.

Payman Langroudi: Which [00:42:15] is a weird story to make up. Like it could be a hundred things. Right. But to make up that story about [00:42:20] what people are thinking about you or. She’s single. Yeah. But then [00:42:25] I talk to lots of young people these days who want to be single. [00:42:30] Like, it’s almost the most common thing that people say to me. Say, are you with No, [00:42:35] no. I’m single. Like. Like actually choose to be single. Not. Not years ago. Yeah. Years ago. [00:42:40] No one would choose to be single. It would be like a like a had to be ended up single. [00:42:45]

Zara: Yeah. I think we’re also coming into a [00:42:50] time where it’s important to know who you are yourself, what you want from life, [00:42:55] what you want from a partner and not actually settling. So you don’t need to settle. There [00:43:00] isn’t this we’re also moving away from, you know, there’s a time you need to do this. You need to do this. You can’t put [00:43:05] that pressure on yourself because then if it ends up not being right for you, it’s only going to [00:43:10] show up six months later. So why not wait for something that actually feels right?

Payman Langroudi: Okay, [00:43:15] but what I’m also hearing from those people [00:43:20] that girls who say they want to be single is when they do want to have kids, they find it hard to find someone. [00:43:25]

Zara: I mean, it really just does.

Payman Langroudi: This resonate, you know?

Zara: Is it [00:43:30] what resonates, resonate?

Payman Langroudi: Is it I’m not talking about with you.

[TRANSITION]: But.

Payman Langroudi: Like with the. With the generation.

Zara: Generation I [00:43:35] think. Yeah. Because, I mean, people are having kids. A lot later nowadays, a [00:43:40] lot more women are freezing their eggs. Yeah. Um, and, you know, so you’re thinking about the future, but you’re [00:43:45] by doing that, you’re just taking the pressure off, which I think is the right thing to do because [00:43:50] there’s no point in getting involved. And then having thinking that having a child is going to help my relationship or [00:43:55] mend the relationship, because it will not the opposite. Quite the opposite, absolutely. And then [00:44:00] it’s just going to be a negative environment for that child as well. Why would you want to do that.

Payman Langroudi: And I think, [00:44:05] you know, there’s that look, you’re an independent, financially independent person now you’re I’m sure, [00:44:10] right. Um, years ago that wasn’t the case, right? The woman would be reliant [00:44:15] on the man for for finance. And then that would push you straight into that. Get [00:44:20] married quickly.

[TRANSITION]: Yeah.

Payman Langroudi: And, you know, as as these lines are redrawn, [00:44:25] um, you often come across a hygienist or a dentist who’s, like, the [00:44:30] primary earner in a family. How do you feel about that? I mean, have you got [00:44:35] like. Like what? Traditional values in as much as you want to be [00:44:40] looked after a little bit, but how do you feel about that?

Zara: I think it’s [00:44:45] extremely important for women to have their own stream of income. It [00:44:50] doesn’t need.

[TRANSITION]: They’re never trapped.

Payman Langroudi: In a situation.

Zara: Exactly. So that you’re independent. If anything [00:44:55] were to go wrong, you know that you can stand on your own two feet. Yeah. It’s extremely important for a woman to be financially [00:45:00] independent at the same time. To be with a partner [00:45:05] who’s also earning is equally as important. I’m not saying that you need to have a CEO job [00:45:10] as a woman can just be like a basic job, but you’ve got your own stream of income, so therefore you [00:45:15] are independent. Now, of course, I love I love what I do [00:45:20] and being financially independent, is it also important for me that I’m with someone [00:45:25] that is also financially independent and works and [00:45:30] earns. Of course it is. Of course I like to be looked after. I do consider myself as like I’m very [00:45:35] pro-women. Women’s rights, feminism and all of that. But also from my background [00:45:40] and seeing how, you know, certain things were taken care [00:45:45] of, the man would look after, you know, from even my family and seeing that growing up, [00:45:50] of course I like it. It’s nice to have someone, you know, who’s going to open the door for you or.

[TRANSITION]: Yeah, [00:45:55] but not everywhere.

Payman Langroudi: Yeah. Like, you know, if you take it to its conclusion. Yeah. Like [00:46:00] I did a lot of work in Holland. My, my biggest customer was in Holland. [00:46:05] And in Holland, men don’t hold doors for women at all. [00:46:10] And if they did, the women get pissed off. Yeah. Like there’s there’s a whole thing, man. Like [00:46:15] they are 100% equal, you know, like they don’t pay for dinner. Yeah. [00:46:20] They don’t. And so it’s an interesting question, you know, like, is that the, the final place [00:46:25] we’re going or, or is their traditional roles like you do want the door open for [00:46:30] you? You do want nice things bought for you or whatever.

[TRANSITION]: Yeah.

Payman Langroudi: You know, it’s an interesting point.

[TRANSITION]: I think. [00:46:35]

Zara: It’s personal. For me personally, I would say yes. At the same time, being [00:46:40] told as a woman, oh, I can’t do this or you can’t do that. I’m just like, no challenge accepted. I’m [00:46:45] going to do it. I’m going to show you. I’m going to do it.

Payman Langroudi: Is that your character? If someone says you can’t do something.

[TRANSITION]: That’s that’s.

Zara: Just [00:46:50] me. Just because I’ve been raised in.

[TRANSITION]: Well, you know.

Zara: What I’ve just been raised seeing especially, [00:46:55] um, seeing my mum going through a lot of difficulty and [00:47:00] coming out the other end and still striving. That’s where my sense [00:47:05] of, yeah, I’m a woman. I can do it. Yeah. Determination that [00:47:10] and Disney films.

[TRANSITION]: Are you into them?

Zara: Well, as a child [00:47:15] you watch Disney films don’t you. So you’re always like, okay, you know, you come out [00:47:20] the other end. But I think maybe the more traditional roles With [00:47:25] even the British cultures like that. Very polite and very, you know. Oh, I’ll [00:47:30] take you out for dinner or I’ll walk on the side of the road that the cars are going down all these things, [00:47:35] which is nice. I like it at the same time. I’m. I still want to [00:47:40] be financially independent. Why can’t, why can’t I have both?

Payman Langroudi: You can. You can do what you like. [00:47:45] Yeah, but you’re a fascinating sort of contrast of all these different things, you know, like East and West. [00:47:50] Yeah. And, and and it’s refreshing. It’s a refreshing thing.

Zara: I like to bring them [00:47:55] together. Not that I’m just this or I’m just that, you know, why can’t I be a [00:48:00] multiple kind of things?

Payman Langroudi: Yeah. You can. Let’s get back to [00:48:05] the darker part of the pod. We like to talk about mistakes. [00:48:10]

[TRANSITION]: Yeah.

Payman Langroudi: Clinical errors, specifically clinical errors. Because, you know, [00:48:15] from black box.

[TRANSITION]: Thinking.

Payman Langroudi: Where, you know, when a plane crashes, they [00:48:20] get the black box. They look at what happened? They figure out exactly what [00:48:25] happened without blame, and then they distribute that information [00:48:30] to the whole pilot community so that no one else makes that same mistake. But [00:48:35] in medical we like blame. Mhm. And so when something goes wrong we [00:48:40] kind of don’t like to talk about it or we’re ashamed of talking about it. And hence [00:48:45] we end up not learning from everyone’s mistakes. I mean, wouldn’t it be interesting that if right now, today, [00:48:50] all the mistakes that happened in practice get published and we could all read them without any [00:48:55] sort of blame being attributed, and just learn the mistakes. Learn from those mistakes. [00:49:00]

[TRANSITION]: I think you get.

Zara: A the next generation of dentists or dental health professionals.

[TRANSITION]: That are way.

Zara: Better. [00:49:05] Yeah.

Payman Langroudi: So, so in in with that in mind.

[TRANSITION]: What do you think? What what. [00:49:10]

Payman Langroudi: Comes to mind when I say clinical.

[TRANSITION]: Errors? A quickly.

Zara: Now that you mentioned that, I [00:49:15] think being in an industry where it’s supportive and people aren’t scared, especially [00:49:20] within your team, like there shouldn’t be any judgement or, you know, things like that. There is. There’s still that fear. And that’s why [00:49:25] people hide and they don’t talk about it. I think that’s what needs to change fundamentally. Um, [00:49:30] there was a case, uh, it was I think it was like the second practice [00:49:35] that I had worked out. So it was quite fresh. And a patient came in. She had diabetes. [00:49:40] She had BP’s of for advanced [00:49:45] gum disease. Perio. And she hadn’t been to the dentist in like five years. [00:49:50] So I took a look, did a gum examination, and then I told her, I said, listen, I’m going to [00:49:55] do my best for you, but I may need you to come back because there’s just so much that needs to be done. [00:50:00] We really need to strip it back. And she understood in the room, thankfully. Thankfully, I [00:50:05] had a nurse in the room that was working alongside me, which you know, is important because [00:50:10] she was there as a witness in terms of medico legal reasons. And she was also [00:50:15] she wasn’t a very big sort of influencer, but she said that I am doing [00:50:20] YouTube videos. Would you mind if I interviewed you, or if you spoke a little bit about the [00:50:25] link between gum disease and diabetes? And I said, yeah, sure I will. Um, so we did that [00:50:30] and then I went home. Uh, finished. Finished the day and [00:50:35] then got a text or an email from the manager at the time saying [00:50:40] that patients complained she’s not happy. Why is only half of my hygiene bin done? And [00:50:45] I said.

[TRANSITION]: Because you’re going.

Payman Langroudi: To come back for the.

[TRANSITION]: Second. Yeah, I did explain.

Zara: You had so much going on. [00:50:50] You’ve got Perrier, your gums are bleeding, you’ve got diabetes. There’s only so much that I can do in one [00:50:55] visit. I did explain that to her. Um, I feel like it could have been handled [00:51:00] a better way. I was then told to. You know, you have to deal with this situation. [00:51:05] You have to offer them a free hygiene so that they don’t write a bad review [00:51:10] or whatever it is. And that’s when your team really need to be there for you, [00:51:15] because you are part of a team. And so you’re you always need to have each other’s backs.

[TRANSITION]: Mhm. [00:51:20]

Zara: Um and obviously it was the first time anything like that had happened. [00:51:25] I felt really scared. I was like, oh my God, what if this goes into like GDC and you know [00:51:30] called my indemnity. And it just it was called.

Payman Langroudi: Your indemnity.

Zara: Blown out of. Yeah. Because I didn’t know what to do. [00:51:35]

[TRANSITION]: I wasn’t given any advice.

Zara: But also I wasn’t in the wrong. [00:51:40] So for me to give a free hygiene, which wasn’t the point. But by me doing that, it’s [00:51:45] the principle of the matter saying that you’re right, and I was in the wrong where I did.

[TRANSITION]: I wasn’t [00:51:50] in the.

Payman Langroudi: Were in the wrong. You were in the wrong because you didn’t communicate properly.

Zara: No, I did communicate. And I had my nurse.

[TRANSITION]: And I [00:51:55] told, did.

Payman Langroudi: She get the message? If you communicated.

[TRANSITION]: Because you get patients.

Zara: Like this that just want a free hygiene and they want to complain [00:52:00] about it.

[TRANSITION]: You do you all the time.

Zara: Payman all.

[TRANSITION]: The time. Of course.

Payman Langroudi: They exist.

Zara: 100%. [00:52:05]

[TRANSITION]: I still get it nowadays. But then listen, listen, listen.

Payman Langroudi: This is an important point. I talk to my team about this all [00:52:10] the time. Right? Enlightened has a B1 guarantee. Yeah. What does that mean? You can contact [00:52:15] us and say, I’m going to be one. Yeah. And we have to give you more. More gel. Yeah. Once [00:52:20] in a while. Believe it or not, some people try and use that system to get more [00:52:25] gel. Yeah. Now, I don’t like it. [00:52:30] It doesn’t make me happy that that happens. Yeah, but what makes [00:52:35] me particularly unhappy? Yeah. Is if someone like you. Yeah. Someone big, enlightened user. [00:52:40] Where it doesn’t always work. If something happens and it doesn’t work. Contacts my team and [00:52:45] says it didn’t work. Send me more gel and my team. Don’t take [00:52:50] that at face value because they’re busy looking for abuse of the system. [00:52:55] Yeah. And my point to my team is I’m happy to get abused a [00:53:00] little bit so that when Zahra calls, who’s a good [00:53:05] user, who’s an honest person, you treat that thing as an honest person and a good [00:53:10] user. So. So my point is, even if this woman was was going for a free hygiene [00:53:15] school for a few of them to slip through the net as long as what if she [00:53:20] wasn’t? What if she actually didn’t hear? You didn’t actually didn’t understand, you know, like that’s the [00:53:25] one if you if you actually didn’t understand.

[TRANSITION]: Absolutely.

Payman Langroudi: And now now you’re kind of being accused of going [00:53:30] for a free hygiene.

[TRANSITION]: But that wasn’t the case.

Zara: This wasn’t the case because I.

[TRANSITION]: You know.

Zara: The number [00:53:35] of times I said in the appointment, like I, you know, and then at the end, I informed [00:53:40] her, I said, look, I’ve done this section, you know, I haven’t done the inside. We’re going to go through this.

[TRANSITION]: What happens? [00:53:45] What I told her so many times.

Zara: So I don’t actually agree with that. The reason is because then patients feel [00:53:50] like they can just keep doing that. And also when you lose. No, because when you lose that [00:53:55] trust between clinician and patient, that’s it. I can’t treat you. I go see another [00:54:00] hygiene. I would rather you see another hygienist. I don’t want to see you because we’ve lost that trust.

Payman Langroudi: I [00:54:05] know, but just if you if you default into they’re always right.

[TRANSITION]: But they’re.

Zara: Not always right.

[TRANSITION]: But you just. [00:54:10]

Payman Langroudi: Default into they are.

[TRANSITION]: Always right.

Zara: Yeah, but.

[TRANSITION]: Anyway.

Payman Langroudi: What happened?

Zara: So basically [00:54:15] it was they wrote they wrote an email, blah, blah blah. Um, because [00:54:20] they just basically wanted to squash it. Um, it was my first experience [00:54:25] and, um, I ended up seeing her again for free. Yes. [00:54:30] And even though that wasn’t the that wasn’t the issue. The the issue was that they kept [00:54:35] just pushing me and telling me that. Just do it. Just do it for free. And then, you know, she. Okay.

[TRANSITION]: So you found. So I [00:54:40] did it. You found it.

Payman Langroudi: Upsetting that they didn’t have your back. That I.

[TRANSITION]: Didn’t have. Yeah.

Payman Langroudi: Yeah, that’s that’s an important point.

[TRANSITION]: Yeah.

Zara: Especially [00:54:45] when you’re first starting out. Yeah. Um, I did it, and [00:54:50] then that was it. And I said, going forward, please don’t book her with me. Please book her with another hygienist. [00:54:55] The patient never, ever returned back to the practice because you can tell she [00:55:00] just she’s she’s created this entire massive scene, and she just wanted the [00:55:05] free hygiene. And apparently when they checked on different reviews, she’d written, She’d written multiple [00:55:10] bad reviews, bad reviews for multiple practices. So you can see that this person [00:55:15] is just sort of wanting. Just.

Payman Langroudi: So where was the error?

Zara: The error was, I think [00:55:20] I would probably say the lack of the team having each other’s backs. [00:55:25] That was where the error was. Yeah. Um, which, you know, when since since then [00:55:30] you do get you can’t make everyone happy.

[TRANSITION]: But there are patients that story. [00:55:35]

Payman Langroudi: That was a nice story.

[TRANSITION]: But but when it happens now.

Zara: Yeah. Easily. You know, book them in with another [00:55:40] hygienist and the team. I’m so very grateful and lucky and really happy with the places that I work at [00:55:45] now. They’ll book them with another hygienist.

Payman Langroudi: That was a nice story, but I’m not accepting it.

[TRANSITION]: Why?

Payman Langroudi: Because [00:55:50] I’m looking for your biggest clinical error. That wasn’t it.

Zara: Um. [00:55:55] My clinical error. Um.

[TRANSITION]: You must.

Payman Langroudi: There [00:56:00] must be. Even if it was, like, a drop or something.

[TRANSITION]: I did actually numb up.

Zara: I did numb up the wrong side [00:56:05] when I was doing perio.

[TRANSITION]: Oh, good. Good.

Zara: And, uh, again, this was like, at the beginning. [00:56:10] When did you.

Payman Langroudi: Notice? When did you notice?

Zara: When I’d finished numbing her.

[TRANSITION]: So I had to numb the way [00:56:15] straight away.

Zara: Straight away after I’d done. Because I was doing the half the mouth.

[TRANSITION]: I’ve done that. Yeah. [00:56:20] And so. And so. What did you say?

Zara: So I basically said [00:56:25] that I’m going to go over this bit again, which I did, and then also did the other side. [00:56:30]

[TRANSITION]: All right.

Zara: But um, after making that mistake [00:56:35] once and I was a bit worried because, you know, I was like, I’m giving her more when she doesn’t need [00:56:40] it.

[TRANSITION]: Yeah.

Zara: Um, you make those mistakes once and then, you know, [00:56:45] it doesn’t. You try.

[TRANSITION]: It doesn’t happen again.

Payman Langroudi: With that man. That’s still not a very big incident.

Zara: I mean, thankfully, [00:56:50] nothing happened.

[TRANSITION]: What about your most difficult patient?

Payman Langroudi: Was that this one? The first one?

Zara: Uh, she [00:56:55] was difficult. I also had a different scenario, which was a bit similar. Um, and [00:57:00] it was a guy who basically said the same thing. He hadn’t been in ages, and I was like, look, I’m. [00:57:05] I can only do what I can do for you in one appointment and basically went downstairs and complained [00:57:10] to reception. Why did she give fluoride when she hadn’t even finished the treatment? [00:57:15] Even though the areas where I applied the fluoride, I completed the hygiene there. [00:57:20] But he said that she wasted time applying fluoride. How long does it take to apply fluoride?

[TRANSITION]: Five [00:57:25] seconds.

Zara: Exactly a minute. But he made a huge a big thing. And he also just wanted free treatment. [00:57:30] And they booked her. And I said, book him in with another hygienist.

Payman Langroudi: But maybe it’s been a short career and [00:57:35] you haven’t got many bad situations, but these these ones just aren’t resonating for me. I mean.

[TRANSITION]: You [00:57:40] end up making more of a mistake. Did you never.

Payman Langroudi: Ever, like, I don’t know, dislodge a restoration. And then the [00:57:45] patient got pissed off with that or.

[TRANSITION]: No.

Zara: Well, no. Luckily.

[TRANSITION]: Cut someone’s.

Payman Langroudi: Lip.

[TRANSITION]: Smacking. [00:57:50] No. There was.

Zara: There was a composite filling that did fall out that came out, but. [00:57:55]

[TRANSITION]: It was calm.

Zara: No, I did tell the patient straight.

[TRANSITION]: Away, but he was calm. It was.

Zara: Yeah, he was very [00:58:00] calm. It was a very lovely patient, actually. And the dentist also just [00:58:05] I was like, look, you’re in the best place right now. We can get this fixed. The dentist can fix it for you and dentist [00:58:10] placed it back in. So maybe you just interview me.

[TRANSITION]: For the best career. [00:58:15]

Zara: No. Well, no. Do you know what?

[TRANSITION]: No mistake. Patients.

Zara: You always get some [00:58:20] patients that aren’t nice. You can’t make everyone happy. But I have been blessed to have really lovely patients. [00:58:25] Yeah, I think where the problem lies is the industry itself.

Payman Langroudi: Go [00:58:30] on then. Yeah.

Zara: In terms of just not having each other’s backs, like we shouldn’t always [00:58:35] be so defensive or like, you know, oh, it’s the patient. Or sometimes even using the patient [00:58:40] instead of actually dealing with the problem within the team. Uh, blaming [00:58:45] it like, oh, because of the patient. Because of the patient.

[TRANSITION]: You like using.

Payman Langroudi: The patient as cover?

[TRANSITION]: Yeah.

Payman Langroudi: Whatever you or your [00:58:50] agenda is.

Zara: Yeah, yeah.

[TRANSITION]: No, we.

Payman Langroudi: Get this all the time in massive arguments, and it tends [00:58:55] to be on Facebook. Yeah, massive arguments between dentists. And sometimes [00:59:00] it’s pretty nasty. It can get properly nasty and almost using the patient as [00:59:05] cover for that, right? But patient’s best interest is cover.

[TRANSITION]: Yeah.

Payman Langroudi: For that argument.

Zara: And [00:59:10] I think once you have that like full backup from the team and you sit down and you sort and you [00:59:15] go through the the problem, how can we improve it so that it doesn’t happen again? Or if it happens, how [00:59:20] do we deal with it? That’s what’s important.

[TRANSITION]: All right.

Payman Langroudi: I’m still not [00:59:25] happy. I mean.

[TRANSITION]: You’re just not.

Zara: You’re just not going to be happy. What can I. You can’t please.

[TRANSITION]: Everyone.

Payman Langroudi: Biggest, [00:59:30] biggest mistake. Like career mistake. Like. Like. Do you actually regret not going [00:59:35] into acting?

Zara: Um, yeah. It’s something [00:59:40] that I do still have a passion for. But also, it’s not something that I can [00:59:45] go for a casting or audition now. And I’ve got full day patients. What do I do with [00:59:50] that? It’s not something that I can be like, oh yeah, I’m just going to do this on the side. You can’t. You either need to devote your time 100% [00:59:55] or you don’t.

Payman Langroudi: Do you insist on a nurse?

Zara: Um, [01:00:00] I do work with a nurse.

Payman Langroudi: Do you insist on it?

Zara: Yeah, I do. [01:00:05] Because the thing is that my quality of my work is not going to be the same. Working without a nurse. I’ve done both. [01:00:10] And the quality of my work is not going to be great. You can’t. How can you do a six point pocket chart [01:00:15] without a nurse? And the periodontist does the same thing and has a nurse? What’s the difference? I’m struggling [01:00:20] to to understand. I think also the patient as well, asking the patient to like hold the [01:00:25] suction. You’re going into private practice, you’re paying all this money. Then you get the patient to hold the suction. I [01:00:30] wouldn’t I wouldn’t feel right in that situation at all. Um, the [01:00:35] appointment runs better. Medicolegal reasons. Um, when [01:00:40] the nurse is cleaning up, doing the instruments, I can then be speaking to the patient, educating them. [01:00:45]

Payman Langroudi: That’s the one for me.

[TRANSITION]: Yeah, that’s a key.

Zara: That’s where you build your rapport.

Payman Langroudi: Yeah. Like, [01:00:50] look, if you measure the total time that you and the patient are talking to each other, it’s [01:00:55] a minute part of the appointment.

[TRANSITION]: Because I know I talk a lot.

Payman Langroudi: I’m sure most [01:01:00] of the appointment, the patients down there, you’re treating them right. So back to my [01:01:05] original thing about your time is best spent selling whitening. You know that someone [01:01:10] doing the cleanup means that that’s seven eight minutes less with the patient. [01:01:15]

[TRANSITION]: Exactly.

Payman Langroudi: Depending on cleanup. Right. The way. The way practices do it. Yeah, but, you know, it could [01:01:20] be anything up to. I mean, I’ve been I used to and then.

Zara: Your notes, you’ve got to you know, that’s when I.

[TRANSITION]: Do my notes as well. Yeah.

Payman Langroudi: Um. [01:01:25]

[TRANSITION]: Although but.

Zara: I do think.

[TRANSITION]: I do come.

Payman Langroudi: Across principals who call that [01:01:30] a diva hygienist. Right.

[TRANSITION]: Yeah. That’s not come across.

Payman Langroudi: I do come across principals.

[TRANSITION]: Who think I’ve heard.

Zara: It as well. [01:01:35]

Payman Langroudi: No, but but just on that basis. Right. If you insisting on an assistant. Yeah, you’re [01:01:40] a bit of a diva. Do you.

Zara: Know why? Because they’re so used to. Oh, it’s the hygienist that’s the cleaner. [01:01:45] Just shove them in the room. You know, one after another, just like a tractor [01:01:50] system. And that’s it. And if they want anything, if they’re going to ask for anything, then they’re known as a [01:01:55] diva. I think that we should be speaking up as hygienists to be able to do your job properly. You know, I need this [01:02:00] or I need that. Why is it okay for the dentist to do? Obviously within reason. You know, it’s [01:02:05] still running a business. I understand that, but at the same time, for me to then be able to [01:02:10] provide the best care possible for my patients and.

Payman Langroudi: To earn right and and to bring money into the practice. [01:02:15]

[TRANSITION]: Yeah.

Zara: And that’s why my patients keep coming back. Because it’s that reports that level of [01:02:20] service. So at the end that’s going to only benefit the practice because [01:02:25] more patients are going to come. Oh that hygiene session was amazing. I’m going to get my husband to come [01:02:30] and see you win for the practice.

Payman Langroudi: So but amongst hygienists what’s the what’s [01:02:35] the sort of thinking on this.

[TRANSITION]: Is it that I think.

Payman Langroudi: All of them would want an assistant if they could get one? Uh, [01:02:40] or.

[TRANSITION]: Do some prefer not to have some.

Zara: Some, some hygienists do prefer to work without [01:02:45] a nurse, and that’s okay. I don’t know.

[TRANSITION]: Boss of.

Payman Langroudi: Their own domain sort of.

[TRANSITION]: Thing. You know, [01:02:50] I don’t know.

Zara: I’m I’m a very open book. You know, the nurse comes in, they can see what I’m doing. They [01:02:55] can see what I’m saying to the patient. And that’s all fine. I’ve got nothing to hide. It’s all out there. I don’t know, [01:03:00] I can’t answer that because I’ve. I don’t like, you know, to work on my own is not something [01:03:05] that I have done in the past, but it’s not my go to. I think the most important thing here is not whether [01:03:10] you want to. You should or you shouldn’t, given you should be given the opportunity. [01:03:15] They should ask, you know, you go for the interview. Do you like to work with the nurse? Do [01:03:20] you work with the nurse? And then so that’s the responsibility of the practice owner. And [01:03:25] then the responsibility of the hygienist is also to voice their opinion. Yes I do. And you say it [01:03:30] to them there and then or no I can work with that one. It just needs to be that [01:03:35] open communication.

[TRANSITION]: I mean.

Payman Langroudi: I don’t want to bring everything [01:03:40] down to money, right? But if if you think about the money, how much does [01:03:45] the nurse earn per hour?

Zara: I mean, I guess it ranges from [01:03:50] 1011 to. I mean, now that I don’t know. 15. [01:03:55] Yeah. Depending on.

[TRANSITION]: So I guess.

Payman Langroudi: Like, you could even frame it like this. You could frame it as [01:04:00] I’m paying the nurse, you know, like in a way.

[TRANSITION]: Yeah. [01:04:05] You know what I mean?

Payman Langroudi: Like, whatever your hourly rate is or I know you’re on a percentage, but but you know that [01:04:10] question.

[TRANSITION]: Yeah.

Payman Langroudi: That question. Maybe that’s why some people want to work alone. They want that £15 themselves. [01:04:15]

[TRANSITION]: No. Because.

Zara: No, don’t be putting that into the heads of dentists. Okay? We’re [01:04:20] not going down that road.

[TRANSITION]: Um, it’s.

Zara: A joint effort. [01:04:25] Even when my nurse is, like, running behind. Or I can see that we’re running late and [01:04:30] she’s, you know, busy, you know, I’m like, okay, go do your instruments. I’ll wipe down or, you know, she’s gone down to get [01:04:35] the patients. I don’t know, in the morning I’ll go down and get the patients in the aft. We help each other out, [01:04:40] and that’s what it really is. It’s about the whole team. And when you’re there for each other. So I don’t [01:04:45] see my nurse as less than.

[TRANSITION]: No.

Zara: And it shouldn’t be that way at all. We’re all equal, and we’re trying [01:04:50] to help each other just so that we can get through the day. And so the patients actually see, wow, this is a really great working [01:04:55] environment. But again, why is it okay for Periodontists to be working with [01:05:00] without. You would never find a periodontist that works alone, always with a nurse. Or [01:05:05] let’s just say this, a dentist who’s doing hygiene. Do you see a dentist doing hygiene without an assistant? [01:05:10] No, I’ve never seen it.

[TRANSITION]: I’ve done.

Payman Langroudi: It. I’ve done it. Um, but.

Zara: It’s not common. [01:05:15]

[TRANSITION]: But I don’t like to do it. Yeah? Yeah.

Zara: When you’ve got four handed, dentistry is gold [01:05:20] standard. Yeah. And it makes a huge difference. That’s what it comes down to.

Payman Langroudi: But [01:05:25] so I mean, what I’m interested in, what our hygiene is saying about this is [01:05:30] because you’d imagine eventually we’re going to get to a situation where it’s the standard. But [01:05:35] right now is it?

Zara: I mean, I can only.

Payman Langroudi: I guess you’re in private practices.

[TRANSITION]: Yeah. [01:05:40]

Zara: And I have worked in mixed practices before, and I had a nurse then. Um, but. [01:05:45]

Payman Langroudi: So is it the standard? I mean, if you go for another job, without asking for it. Do you reckon [01:05:50] a nurse is available on average or no? Are you are you.

[TRANSITION]: Where you.

Zara: Go? [01:05:55] It really depends on where you go, what kind of practice it is.

[TRANSITION]: Yeah.

Zara: Um, I think it’s [01:06:00] more common now post Covid. Definitely. You know, working with airflow, definitely. [01:06:05] All these things. I think it’s changing and it should because otherwise you’re just you’re [01:06:10] without even saying anything. It’s just like, oh, the cleaner they can just do the job on their own. [01:06:15] And it’s not like that because it’s an isolating job as it is.

[TRANSITION]: Yeah. [01:06:20]

Zara: So you can’t be. It will it will crush you.

Payman Langroudi: As [01:06:25] a hygienist. Right. You must get a lot of toothpaste [01:06:30] manufacturers, mouthwash, all of that. They’re the biggest [01:06:35] companies in dentistry. I mean, we like to talk about Invisalign and all that, but but you know [01:06:40] Procter and Gamble, Colgate. These guys are gigantic, right?

[TRANSITION]: Yeah.

Payman Langroudi: Um, Do [01:06:45] you get asked by patients like what’s what’s the best toothpaste? Does that happen?

[TRANSITION]: Yeah, all [01:06:50] the time. What do you say?

Zara: I mean, it’s very overwhelming as a patient because there’s so much out there. You [01:06:55] go into the supermarket and you’re like, oh my God, what do I choose?

[TRANSITION]: Yeah. What do you.

Zara: Say? Most important thing for me is that it has fluoride [01:07:00] in it. If the anti-fluoride then at least hydroxyapatite if they [01:07:05] experience dry mouth. No SLS. It depends on what the patient’s got going on if they’ve got sensitivity. [01:07:10] So I would always tailor it to, to the patient needs. But obviously of course I’m going to [01:07:15] say it needs to have fluoride because that’s going to, you know, make the enamel strong and help protect against [01:07:20] tooth decay.

Payman Langroudi: Are you seeing more and more people being anti fluoride?

Zara: I think [01:07:25] there has been an increase because of the sort of holistic side of things, [01:07:30] and patients don’t want to be putting, I don’t know, chemicals into their body. Um, [01:07:35] so a little bit more now nowadays than before. Yeah.

Payman Langroudi: I think it’s a [01:07:40] massively growing area. Yeah. And I think the question needs to be answered, right? That, [01:07:45] you know, if I don’t want to put fluoride in my toothpaste, what is the best toothpaste? You’re like [01:07:50] what you said there about hydroxyapatite. Great, right? Um, because, you know, [01:07:55] like, I don’t know, maybe someone wants to have fluoride toothpaste every other day just [01:08:00] to halve their dose for whatever reason. Yeah. All right. What should I use on the other day? [01:08:05] Like, which is the right toothpaste? Right. And and so that I see that conversation. [01:08:10] People are asking me in dinner parties about fluoride these days. It’s like become a big, big, big question. [01:08:15]

[TRANSITION]: Yeah.

Payman Langroudi: And have you heard Trump is.

[TRANSITION]: The Trump is going to be.

Zara: Taking it. Yeah.

[TRANSITION]: He’s going to be taking [01:08:20] it out of the water. Yeah. Yeah. I mean.

Payman Langroudi: I don’t know how I feel, but I’m kind of calm [01:08:25] with no fluoride and water.

Zara: You know what I don’t? Yeah, I am. I also feel calm [01:08:30] about that as well, because as long as you’re using.

[TRANSITION]: Medication.

Payman Langroudi: Of the whole population, it’s a bit weird if.

Zara: You’re using [01:08:35] it in your toothpaste and it’s such a minute amount that it’s not actually going to damage the body. And if you think [01:08:40] about it, the majority of that you’re spitting out anyway? Yeah. So it’s just a very thin film [01:08:45] that’s covering the teeth. So it’s not in any way going to be [01:08:50] harmful for the body. It’s only going to help the enamel of the teeth. Um, as long as you’re using your toothpaste, [01:08:55] toothpaste, fluoridated toothpaste, then I don’t think we need fluoride in the water. But that’s [01:09:00] just my opinion.

Payman Langroudi: I’ve got a thing I call the aha question. It’s [01:09:05] a weird one. It’s like. It’s a bit unfair as well, but it’s like, what’s what’s [01:09:10] your aha moment around perio? Like, you know, you say I love gums. [01:09:15] Yeah. When was the moment where you thought, oh I get it. Like there’s something [01:09:20] like a, there’s something I understand.

Zara: When they come for [01:09:25] the response to treatment. So I’ve done the non-surgical cryotherapy. [01:09:30] I’ve done that course. Leave them. Then they come back for their response to treatment appointment. And [01:09:35] I redo the six point pocket chart. And those numbers have come down and there’s no bleeding. [01:09:40] Yeah. And I’m honestly just seeing that when I’m doing [01:09:45] it, I’m like.

[TRANSITION]: Yes, it’s fulfilling. Worked.

Zara: The patient listened to me. They’re doing their home care. [01:09:50] They’re having their, like regular hygiene visits. The gum disease is stable because of that link [01:09:55] to the rest of the body as well. I’m just like, wow, we really are in a way, saving lives. [01:10:00] But in terms of gums, when I go through the chart with the patient and I compare the old chart with the new [01:10:05] chart and they can see for themselves, they’re like, wow. I’m like, yeah, don’t underestimate.

Payman Langroudi: It is [01:10:10] a funny thing though, because like on that visit, they might be like that because they’re in that part of [01:10:15] the cycle where, you know, the host response isn’t messing them up. And then three months later it [01:10:20] can be back to the old situation.

Zara: I’ll check it. I’ll check it in three months as well.

Payman Langroudi: Yeah. But when I say [01:10:25] aha, I don’t mean fulfilling. I mean when I’m where you figured it out somehow there was something [01:10:30] about it. There was a moment where you thought, oh, I’m really good at this. For this reason, I understand [01:10:35] it more now. What moment comes to mind when I say that. I [01:10:40] mean, for instance, you’re at a health society. Yeah. Yeah. Like over there. They’re doing what? That collagen breakdown.

[TRANSITION]: Measurement [01:10:45] microbiome before.

Payman Langroudi: And after treatment. I mean, that must be really interesting. [01:10:50] Tell me a bit about that.

Zara: It’s different. That’s why I like. Because it’s it’s different. It’s not like your sort of everyday generic, [01:10:55] um, hygiene work.

[TRANSITION]: Yeah.

Zara: And seeing again the numbers, it always [01:11:00] comes down to the numbers because when the patient can see something, whether it’s in the mouth or whether it’s in numerical [01:11:05] value.

[TRANSITION]: It’s more tangible.

Zara: That’s exactly that’s what. And then they understand it and then they get it. [01:11:10]

[TRANSITION]: Yeah.

Zara: And that’s just like I’ve done my job. It’s so satisfying [01:11:15] because I’m like, you understand now you’re improving. You’re doing your job. I’m doing my [01:11:20] job. And together mutually, we’re getting to general well-being, which is health. And [01:11:25] then when you achieve that, it’s about optimising it. So it’s not like, that’s it. My job’s done. [01:11:30] It’s about continuing it. Otherwise you’re going to relapse.

Payman Langroudi: What do you think of floss? [01:11:35]

[TRANSITION]: Love floss, but.

Payman Langroudi: It isn’t floss. A waste of time.

[TRANSITION]: No, it’s not a.

Zara: Waste of time. [01:11:40]

Payman Langroudi: Because, like you. Interdental brush. Right.

[TRANSITION]: I mean.

Zara: Okay, so the interdental brushes [01:11:45] are the gold standard, especially if you’ve got perio, if you’ve got big gaps for patients that have tighter [01:11:50] gaps and they can’t get those interdentals in.

[TRANSITION]: Then tiny ones.

Zara: They you [01:11:55] know what? Sometimes with the tiny ones, they go in and they’re heavy handed and they just bend. And once they bend, [01:12:00] there’s there’s no point. But it’s also about the technique of the floss. So if you’re going down slightly under [01:12:05] the gum, doing that C shape going up and down, you’re removing that plaque rather than just going in with the [01:12:10] floss and coming out. And that’s doing.

[TRANSITION]: Nothing. Yeah, yeah.

Payman Langroudi: But still, you know, like the reason why.

[TRANSITION]: I floss every night, [01:12:15] I.

Payman Langroudi: Don’t think floss does enough. I’m sure it does something. Yeah, but the [01:12:20] reason I’m saying it is like the like aha moment. Yeah, yeah. This was my aha moment [01:12:25] on floss. Yeah. That the root surface isn’t just conical. [01:12:30] Yeah. It’s conical and Undulating and in and out and. [01:12:35] Yeah. So that’s why you get plaque building up there. Because [01:12:40] it’s not just this perfect circle. Yeah. It’s rough and it’s a little bit, you know, there’s [01:12:45] sometimes it goes in and out. Yeah. So floss can’t get into those nooks and [01:12:50] crannies. Yeah. And it’s the nooks and crannies where you’ve got where there’s a problem. [01:12:55] Yeah. So for that reason, you know, like, okay, if I’ve got [01:13:00] this perfectly round teeth floss, but I’m not going to have any problems if I’ve got these perfectly round teeth. [01:13:05] It’s in the nooks and crannies where problems occur.

[TRANSITION]: Yeah.

Payman Langroudi: And so that’s why I think incidental. [01:13:10]

[TRANSITION]: But in those I wouldn’t.

Payman Langroudi: Even for me, it’s a bit confusing for the patient to teach them [01:13:15] flossing properly, because that’s quite a job where the benefit of it is nowhere near as good as the benefit [01:13:20] of interdental brushing.

Zara: It depends. It always comes down to technique. There’s a technique when using your interdental [01:13:25] brushes. There’s technique when you’re using floss.

[TRANSITION]: I know, I know, but.

Payman Langroudi: You’ve got this amount. You’ve got X amount of time to teach the patient. Yeah. [01:13:30] So I would say use that time on interdental brushes because there’s so much better.

[TRANSITION]: Than I think. [01:13:35]

Zara: Also a combination, depending on what they’ve got going on. A combination of the two, because then the interdental brushes [01:13:40] will get in between, and then the floss will get into the contact between the contact point. So [01:13:45] I they both have their own roles.

Payman Langroudi: But you know, I remember you don’t [01:13:50] remember this before your time. I remember when electric toothbrushes came out. Yeah. And for the first I’d [01:13:55] say 15 years of electric toothbrushes, all the periodontists [01:14:00] and all the hygienists were saying no, no, no, that they’re not good. Manual brush is just as [01:14:05] good and better than electric brush. And then at one point it just became it became obvious [01:14:10] the mountain of evidence came in. But but it was so obvious [01:14:15] from the beginning that they were better. Yeah, but there’s a legacy thing, you know, and I feel like [01:14:20] floss is a bit like that. There’s a legacy thing with floss. It’s like we’ve been saying it for such a long time that. [01:14:25] But I don’t know, man. If I was a hygienist, I wouldn’t spend the time because it takes time [01:14:30] to teach a person to floss, and I don’t think they ever really learned, do they?

[TRANSITION]: Do you know what?

Zara: Sometimes no. They [01:14:35] do some. You know, I’ll have patients that come in because I will. I’ll go through them. I’ll go. I’ll show them how to do the [01:14:40] technique in the mouth. And then if they come back and, you know, you’ve still got like high bleeding, high plaque [01:14:45] score, you know, you’re missing in between the teeth. Show me what you’re doing at home so I can check [01:14:50] to see if they’ve learned. And they’ve taken my advice.

Payman Langroudi: That’s the nuance, right?

Zara: Yeah. Once they show me, then [01:14:55] I’m like, okay, now remember, you know, the C shape under the gum. So it’s just that reinforcement. And you [01:15:00] know, you’re doing that. You’re seeing them more often than the dentist is seeing the patient. So you have the opportunity to really, [01:15:05] really educate and hone that in.

Payman Langroudi: I feel like, you know, a massive part of your job [01:15:10] is changing behaviour.

[TRANSITION]: Mhm.

Payman Langroudi: Like it’s gigantic part of your job.

[TRANSITION]: Yeah.

Payman Langroudi: And [01:15:15] I’m not sure whether they teach you that or not like because behaviour change like it’s [01:15:20] so much more important.

[TRANSITION]: The hardest thing.

Payman Langroudi: No. It’s so much more important for the hygienist to learn how to change [01:15:25] someone’s behaviour than it is to know about the in-depth cytokine interleukin. [01:15:30] Yeah, I know you go quite deep into the side of it. The host [01:15:35] response. And yet this side of it. Yeah. How do you get someone to change their their behaviour. [01:15:40] I mean, you must have stories of patients where they’ve been resistant to change or patients [01:15:45] that you’ve unlocked them.

[TRANSITION]: Yeah. Well, um, what comes to mind?

Zara: So, [01:15:50] I mean, it’s really important just to always. I’ll ask with them. I’ll. [01:15:55] I’ll ask them and say, you know, we’ll go through this first just so that you’re happy with the technique. Um, and [01:16:00] some of the patients are fine with it. Happy with it. Sometimes you do get the patients that are like, not, you [01:16:05] know, I don’t want to do it. I’ve had patients that are like, no, I don’t floss and I’m not going to floss. I’ll come see you every three months [01:16:10] though. Yeah. Okay. You can’t make everyone happy. Fine. I’m not going to be killing myself. [01:16:15] And at the beginning, I did. I really did because I was like, it’s my job and I need to. I need to change their behaviour. [01:16:20] And, you know, I want them to get better and you cannot, you can’t. And the stress [01:16:25] and the pressure you’re putting on yourself. There’s only so much I can do as a human being. Um, [01:16:30] and then I’m like, fine. So he comes and sees me every three months.

Payman Langroudi: My, [01:16:35] you know, my personal bugbear about us as a profession is we haven’t got the message over [01:16:40] on Frequency of sugar. Yeah, we definitely got the message over on sugar. [01:16:45] Then we got the message over on brushing. Like, every like every. If we asked 100 people [01:16:50] out in the street, 99 of them would know. Brush your teeth. Don’t have sugar. But [01:16:55] what percentage of people of that 100 would know? Actually, it’s not the sugar, it’s the frequency. [01:17:00] A tiny.

Zara: And that’s what I spend on every single patient that comes and sees me in their first appointment. [01:17:05] I go through that. I go through the diet and I tell them it’s the frequency and not the amount.

[TRANSITION]: That [01:17:10] they’re having.

Zara: Because patients are like, okay, so then I can just, you know, have as much sugar [01:17:15] as I want, but if I keep it to a shorter amount of time, then it’s fine. And I’m like, yeah, it’s better for your [01:17:20] dental health, maybe not for your general health, which is also true.

Payman Langroudi: Even in your general health. You don’t want lots of peaks [01:17:25] of, like, sugar peaks. That’s what brings on diabetes.

Zara: So if you’re having sugar after your lunch or after [01:17:30] your dinner, then that’s already counted as one sugar acid attack, because then you’re not. It’s about the frequency. [01:17:35] And so I explain this to me and then they understand. They’re like, no one’s ever told me this. Now it makes.

[TRANSITION]: Sense. Yeah. [01:17:40]

Payman Langroudi: I think as a profession, we’ve failed on that. I mean, or maybe, I mean, I know it’s the same in marketing, right? [01:17:45] There’s only a certain number of messages you can get over. Yeah. I mean, if we do an ad, right? [01:17:50] I always focus on one thing. One thing, and repeat that thing. Your attention.

[TRANSITION]: Span is just. [01:17:55]

Zara: Not there anymore.

[TRANSITION]: Yeah.

Payman Langroudi: What would you do if you had, like, a day off [01:18:00] and you had no one to report to? Nothing. No, no. No sort of jobs? [01:18:05] No. No expectations of you. What would you do?

Zara: Um. [01:18:10] Travel.

[TRANSITION]: He’d love [01:18:15] it that much.

Zara: Yeah, I love it. I love it because of the experience that you gain. [01:18:20]

Payman Langroudi: Yeah, but if you had half a day.

[TRANSITION]: Okay, fine.

Payman Langroudi: If travel was.

[TRANSITION]: Impossible. Um. [01:18:25]

Payman Langroudi: Are you, like, your sister? Do you go to the gym a lot and all of that?

Zara: I can’t [01:18:30] lie. I don’t. I don’t like the gym. I know that I need to do strength training because she goes on at me all the time, which is important, [01:18:35] because now I’m, you know, 34. It’s it’s it’s. Yeah. The body is not what it [01:18:40] used to be.

[TRANSITION]: 34. Yeah.

Zara: Um, so I love [01:18:45] dance workouts. I love, love, love dance. It’s a huge thing. Whenever I’m low, [01:18:50] if I’m, you know, going through a depressed period or whatever, it always increases [01:18:55] my mood. Um, any kind of dance I love, um, salsa, tango, [01:19:00] belly dance.

[TRANSITION]: Oh, really?

Zara: Persian dancing. Like, I just love it. And, um, [01:19:05] massage as well. Like, I will go in, and especially with our job. My head’s [01:19:10] down all day.

[TRANSITION]: Yeah, it’s.

Zara: And it really is just that one time I just switched my phone off, and [01:19:15] it’s it’s just my happy place.

[TRANSITION]: Do you use loops?

Zara: I do, and [01:19:20] routinely. Yeah, well, before I didn’t. But now with the ergo loops I can keep my back [01:19:25] straight. And they’re just now I don’t work without them really. Whereas before I would be like, [01:19:30] okay, I’m gonna take my loops. Maybe if I’m if I don’t have them, blah blah blah, then it’s not a big deal. And now that I’ve tried [01:19:35] these, it makes a huge difference for my back being down and, you know, [01:19:40] straight up.

Payman Langroudi: Where do you reckon if I invited you back on this show, like in seven [01:19:45] years time, where where do you think you’re going to be career wise? Like what [01:19:50] would be a great outcome?

Zara: Mm. Um, so [01:19:55] currently I’m also studying for my level seven facial aesthetics. So also [01:20:00] incorporate going down that route.

[TRANSITION]: Have you done.

Payman Langroudi: Level 1.

[TRANSITION]: To 6.

Zara: So no, it’s not like that. [01:20:05]

[TRANSITION]: Is it though. So it’s like level seven means it’s like a diploma. Level seven is.

Zara: Like [01:20:10] the master’s.

[TRANSITION]: Course. It’s what the.

Zara: Surgeons are doing. Now I could have just done like a short one day, two day course, but I was like, [01:20:15] I want the biggest, longest course out there. You know, I’m someone that I am a nerd, [01:20:20] and I want to make sure that I know everything. Completely. Everything. Um, and [01:20:25] so, yeah.

[TRANSITION]: I started training.

Zara: With BTC.

[TRANSITION]: Oh, really?

Zara: Uh, BTC. Yeah. [01:20:30] With Hari Singh. Yeah.

[TRANSITION]: And, um, so you haven’t started yet? No, I.

Zara: Have started it, but it’s like a year and a half. [01:20:35] Um. Master’s course.

Payman Langroudi: You haven’t started treating patients?

[TRANSITION]: No.

Zara: So basically [01:20:40] doing the theory. Um, and then I’m going to be doing the foundation [01:20:45] in next year in January. Um, and then once I do that, then I’ll be able to [01:20:50] treat patients at the same time as completing the master’s course on the side.

Payman Langroudi: And what’s the commitment?

Zara: Uh, [01:20:55] it’s it’s basically theories all online. And then you see the training is in person, [01:21:00] the clinical training. And then you also observe more models. [01:21:05] I think it’s like 20, um, for each Botox fillers. And then obviously like the dissertation [01:21:10] part as well. So it is intense. But you know, it’s something that [01:21:15] I want to do. So I was like, I want to do the biggest course. Also, aesthetics is not regulated [01:21:20] in the UK and who knows what’s going to happen if they do bring in regulations. I don’t need to worry [01:21:25] about it. I’ve got this. But alongside this, I think business is [01:21:30] something that I really enjoy and want to go down that route. [01:21:35]

[TRANSITION]: So you don’t.

Payman Langroudi: Strike me as that.

[TRANSITION]: Type? No, no.

Zara: I think just [01:21:40] having.

Payman Langroudi: You do strike me as someone who’d be, like, highly successful, you know.

[TRANSITION]: Like having [01:21:45] something else on the side.

Payman Langroudi: No, no, but highly successful hygienist, right? I can imagine you wooing your patients [01:21:50] and getting them back every two months or three months and whitening and all. I get that. Yeah, [01:21:55] but you don’t strike me as the type who wants to do business, do you?

[TRANSITION]: I got [01:22:00] you wrong.

Zara: Because I’m not going to be able to do this for the rest of my life. And I don’t want to be 70 bending over [01:22:05] treating patients. So there’s only so much. So that’s why I’m just trying to think in the future, [01:22:10] what can I do where I’m not physically, you know.

Payman Langroudi: I [01:22:15] see. All right, so seven years time, you’re going to be botoxing people. [01:22:20]

Zara: I mean, sooner than that.

[TRANSITION]: In where.

Payman Langroudi: Like, are you going to have your own place? [01:22:25] Is that how you feel?

Zara: Um, once I start, obviously it makes sense to [01:22:30] treat patients in practice because I’m already working there. But, um, who knows? I think [01:22:35] that’s something that it’s nice to have your own business. Your own something that’s yours. Everyone else [01:22:40] you know does it, and it’s it’s nice. You need to want it, but I think. Yeah. Why [01:22:45] not?

Payman Langroudi: Well, yeah, I mean, I came across I have a dental [01:22:50] nurse who she owns ten practices. Mhm. Would you like to own a practice?

Zara: I [01:22:55] had thought about it in the past. Yeah. Um, now recently joining two squat practices [01:23:00] I can see how much work goes behind. It’s literally it is 24 over seven Sunday. [01:23:05]

[TRANSITION]: Whatever. Yeah.

Payman Langroudi: It’s three years. Three years.

[TRANSITION]: Of pain. It’s. Yeah.

Zara: You really, really [01:23:10] need to be devoted to it. You really need to want it.

[TRANSITION]: Yeah.

Zara: Um, there are hygienists that [01:23:15] have their own practice. I have thought about it. Um, I’ve also there are hygienists [01:23:20] there that, you know, will just rent out a room or rent out a space. Um, which I’ve done in [01:23:25] the past as well. So I think, yeah, there are opportunities there. [01:23:30] One’s more flexible than the other. You just really need to figure out what it is that you want.

Payman Langroudi: And do you think [01:23:35] that going forward, you’re going to be teaching?

Zara: Um, I do [01:23:40] like the idea of lecturing.

[TRANSITION]: And teaching.

Zara: Especially well with [01:23:45] guided biofilm therapy. Um, going down a little bit further [01:23:50] in that field. And, um, but also there’s skills [01:23:55] that we’re not taught at dental school and just being able to manage people. Dentistry [01:24:00] is a people business. It’s not about teeth. And you need to be treating [01:24:05] every.

[TRANSITION]: Individual people skills from you know, I don’t know, did you ever.

Payman Langroudi: Work in retail? [01:24:10]

Zara: I did. I actually used to work in the bookshop at Harrods.

Payman Langroudi: Oh, really? [01:24:15]

Zara: Well, that was one of my jobs.

[TRANSITION]: One of my like. That’ll help. Yeah.

Zara: Um, I also used to [01:24:20] work at one of Gordon Ramsay’s restaurants.

[TRANSITION]: As what? Pub?

Zara: Restaurant? As a waitress. This was, like, [01:24:25] really early on when I was obviously doing that on the side of doing the acting as well.

[TRANSITION]: Oh, [01:24:30] in.

Payman Langroudi: Between genetics and hygiene?

[TRANSITION]: Yeah. Anywhere else?

Zara: Um, [01:24:35] bar like hostess.

[TRANSITION]: Club hostess? Oh, really?

Payman Langroudi: Okay, [01:24:40] so now it’s coming out. But because I think, like, retail is the place where you learn to [01:24:45] really be a people person, you know?

Zara: But I think also you need you need all those skills. That’s why [01:24:50] I’m like I don’t encourage, you know, the younger generation to just go in, go to university, [01:24:55] pick a few subjects, like just figure out what it is that you want to do. Like it’s okay. You can you’ve got time. [01:25:00]

Payman Langroudi: Number of people I’ve had in here who are super successful and I’ve [01:25:05] sort of had pattern recognition that many of them had, like [01:25:10] parents who gave them a budget and anything over that budget they had [01:25:15] to go work for and had a job as a kid. And by having [01:25:20] a job as a kid met the public. Yeah. Number one so they [01:25:25] figured out how to talk to people, but even understood what a business is. I mean, I remember [01:25:30] the first business I really understood was my place. I mean, yeah, I [01:25:35] worked in Oxford Street for two weeks, but, you know, I really understood it. And that was this late? [01:25:40] Yeah. Um, it’s an interesting thing, you know, like like your [01:25:45] your life skills have nothing to do with, with, uh, necessarily hygiene. [01:25:50] Yeah. It’s to do with a combination of acting and club promoter. [01:25:55]

[TRANSITION]: I mean, life life experience. Yeah. Life experience, which.

Zara: Is so important. And you don’t get taught [01:26:00] that. And you just need to go out there and you just learn. I want to say you learn on the job. [01:26:05] Yeah. You just learn by doing.

[TRANSITION]: Yeah. And you know.

Zara: You will make mistakes. But that’s [01:26:10] okay. Life goes on.

Payman Langroudi: It’s been a massive pleasure. I’ve really enjoyed it. We’re going to get to our last [01:26:15] questions, which are always the same. You said you listened to this, right? Fantasy [01:26:20] dinner party. Three guests, dead or alive. Um, are you [01:26:25] having.

Zara: So.

[TRANSITION]: Emily Pankhurst. Oh, really? Yeah. Women’s rights. [01:26:30]

Payman Langroudi: She’s buried, I think, in Brompton Cemetery. Yeah.

[TRANSITION]: Near me.

Zara: Um, obviously, [01:26:35] I’m a huge, huge advocate for women’s rights and equality, [01:26:40] so. Yeah, I think that would be amazing. And, um, Reza [01:26:45] Pahlavi, the Shah of Iran.

[TRANSITION]: The Shah himself. Yeah.

Zara: Who’s dead now? [01:26:50] Um, and also Robbie Williams.

[TRANSITION]: I [01:26:55] love Robbie Williams. I love Robbie Williams.

Zara: It’s like, you know, someone who just brought so much joy to everyone and then ended [01:27:00] up committing suicide, sadly.

Payman Langroudi: Yeah. Anthony Bourdain.

[TRANSITION]: Yeah. [01:27:05] Also same story. Yeah.

Zara: We need a whole nother podcast just on food.

[TRANSITION]: But I know, [01:27:10] I know.

Payman Langroudi: Why the Shah.

Zara: Um, I think because I feel like people [01:27:15] were. So there was so much tourism in Iran. You know, we were up here. Now I [01:27:20] feel like it’s kind of, you know, people just think of Iran as, oh, this like [01:27:25] desert. And it’s not like that at all. We had the double decker buses. We were high in fashion [01:27:30] and we had Concorde.

[TRANSITION]: So much, so much.

Zara: We had so much. And I think it would [01:27:35] just be so interesting to speak to him and just be like, you know, yo, like what happened? [01:27:40]

[TRANSITION]: Yeah. Yeah, yeah.

Payman Langroudi: Agreed. Final questions. It’s [01:27:45] a deathbed question. It’s a bit weird with someone so young, but on your deathbed, [01:27:50] surrounded by your loved ones grandchildren’s grandchildren. [01:27:55] Three pieces of advice you can give them. What would they be?

Zara: Don’t [01:28:00] put pressure on yourself. You don’t need to be so hard on yourself [01:28:05] because at the end of the day, everything is going to be okay. It’s not the end of the world. [01:28:10] Whatever it is, it will pass.

[TRANSITION]: How do you.

Payman Langroudi: Know?

[TRANSITION]: Because it’s just life, [01:28:15] you know.

Zara: I’ve had.

[TRANSITION]: You’re right. Stuff that.

Zara: Things that have happened. [01:28:20] I’m sure I’m going to have bad things that are going to happen, but, um, it will pass. [01:28:25] Um, the other one is travel, because that’s [01:28:30] where you get your experience and you meet different people. And that’s what life is really. [01:28:35] For me, it’s about experience. It’s never I’m not someone who’s just like, I’ve. I always want [01:28:40] more. I want to learn more. I want to experience more. Um, and [01:28:45] don’t be afraid to ask for help because [01:28:50] there’s there’s nothing wrong with asking for help.

Payman Langroudi: And people want to help, you [01:28:55] know? Yeah, people want to help that much more than people think. Yeah, people want to help. It feels [01:29:00] good to help, you know?

[TRANSITION]: Yeah, yeah.

Zara: Even if someone asked me, like, directions on the road, I’m like, okay. [01:29:05] And I’m just like, oh, yeah, that’s nice. It’s just something like, very small.

Payman Langroudi: But it’s [01:29:10] been a massive pleasure. I really enjoyed it.

[TRANSITION]: Really. Thank you so.

Zara: Much for having me.

[TRANSITION]: Likewise. [01:29:15]

[VOICE]: This is Dental. Leaders the [01:29:20] podcast where you get to go one on one with emerging leaders in dentistry. [01:29:25] Your hosts Payman Langroudi [01:29:30] and Prav Solanki.

Prav Solanki: Thanks for listening guys. If you got this far, [01:29:35] you must have listened to the whole thing. And just a huge thank you both from me and pay for actually [01:29:40] sticking through and listening to what we had to say and what our guest has had to say, because I’m [01:29:45] assuming you got some value out of it.

Payman Langroudi: If you did get some value out of it, think about subscribing. [01:29:50] And if you would share this with a friend who you think might get some value out of it [01:29:55] too. Thank you so, so, so much for listening. Thanks.

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

Payman Langroudi: This podcast is brought to you by enlighten. One of the most common questions I get is how do I do more teeth whitening? [00:00:05] The basis of that is to really believe in it, and the basis of that is to fully understand it. Join [00:00:10] us for enlightened online training on Enlightened Online Training.com to understand [00:00:15] how to assess a case quickly, how to deliver brilliant results every time. Next time whitening [00:00:20] underwhelms try and lighten.

Alex Hadley: I mean, it’s nuts and bolts pay. Yeah. It’s not. It’s not rocket science. [00:00:25] I think everyone’s terrified about it. It’s, um. No, as long as as long as you’re in itself. Don’t be scared [00:00:30] of it. Yeah, I don’t know. Well, Sanj Sanj explained it very well and he said, does anyone want to have a go? And I said, yeah, I’ll. Yeah, [00:00:35] fine. And it’s only, you know, it’s they’re only screwdrivers and tiny screws. Just don’t [00:00:40] drop them. That’s it. Just don’t drop the screws. Yeah. Or make sure you’ve got some spare screws. It’s handy. [00:00:45] Spare ones are good. They’re quite tricky to find. Um, yeah, I don’t know. [00:00:50] Restore restoring implants. Fairly straightforward. Um, making implants look [00:00:55] like teeth. Very different story.

[VOICE]: This [00:01:00] is Dental Leaders the [00:01:05] podcast where you get to go one on one with emerging leaders [00:01:10] in dentistry. Your hosts [00:01:15] Payman Langroudi and Prav Solanki.

Payman Langroudi: It [00:01:20] gives me great pleasure to welcome Alex Hadley onto the podcast. Alex is a young dentist, [00:01:25] young under 30.

Alex Hadley: Young I’m just under 30. Yeah yeah.

Payman Langroudi: Yeah. Young dentist [00:01:30] who I met at Bard.

Alex Hadley: Yeah.

Payman Langroudi: That’s right. January last year. [00:01:35] And you know, sometimes you just see fire in someone’s eyes, um, and passion. [00:01:40] And I straight away said to him, you should come on to the podcast because [00:01:45] put that passion out a little bit. But then later on I looked at your work and it’s beautiful work and [00:01:50] it’s quite complex work. Some of it, um, and quite impressive for someone of your age to [00:01:55] be doing that kind of implant work. And I saw [00:02:00] the composite bonding was beautiful. That’s very.

Alex Hadley: Kind.

Payman Langroudi: Very porcelain veneers were nice. Yeah, it’s all nice work. [00:02:05] Um, and I remember being 29, I think we started enlightened [00:02:10] when I was 29. Wow. So sometimes at that age, you kind of want to make a real difference. You know, [00:02:15] you kind of know where you’re at. Um, anyway, lovely to have you.

Alex Hadley: Yeah. Thanks [00:02:20] for having me on.

Payman Langroudi: Pleasure, pleasure. And one of the things about you is you’re incredibly [00:02:25] busy because we’ve been trying to fix this date since January. [00:02:30] Mhm. Yeah.

Alex Hadley: Yeah I do, I do keep myself quite busy I think.

Payman Langroudi: How many days do [00:02:35] you work.

Alex Hadley: Um it varies. Uh, this week, this week you caught me on a good week. [00:02:40] Um, I was only in three days this week. Okay. A nice chilled week, but.

Payman Langroudi: Generally 5. [00:02:45]

Alex Hadley: Or 6. Next. Well, so next week I’m in four different practices across [00:02:50] five days. Um, yeah. I try and simplify things by using one technician. [00:02:55] So that’s like the, the easier thing to do. Um, but yeah, it’s tricky organising, [00:03:00] you know, which lab works going where, you know at what time. And it’s, [00:03:05] it’s yeah, it’s often, often tricky work. So, um. Yeah.

Payman Langroudi: Don’t [00:03:10] you find I mean, it’s it’s complicated. I find I would find it difficult to use [00:03:15] lots of different nurses equipment and all of that.

Alex Hadley: I’m very lucky, [00:03:20] actually. The nurses are. The nurses are really good. Yeah. Um, nurses.

Payman Langroudi: Do you actively train [00:03:25] your nurse when when someone says you go to a practice and say, this is your nurse? Yeah. Do you start? Is there [00:03:30] a way you like things done that you try and get over to that nurse?

Alex Hadley: I, I think often the, [00:03:35] the nurses who either put themselves forward for, say, implant nursing, um, or end up [00:03:40] unlucky enough to work with me. Um, they are they already have some kind [00:03:45] of acumen for it. I think the I think the best nurses are kind of overqualified [00:03:50] for the job. Um, they’re, uh. Yeah, they’re really impressive. [00:03:55] And, you know, you couldn’t do you couldn’t do any of that work without them. Um, I do, [00:04:00] I think I don’t actively train them. I’ve seen dentists sit, sit nurses [00:04:05] down and say I want everything set out like this, I want everything. I don’t do that. Um, they [00:04:10] they kind of pick up the best nurses, pick up what you want, kind of what you’re asking for. [00:04:15] Yeah. And so, you know, within, say, a few weeks or a few months, I don’t have to ask for [00:04:20] something. It’s just.

Payman Langroudi: But what are you working in? Lots of practices. On purpose or by mistake. [00:04:25]

Alex Hadley: So I wouldn’t necessarily say by mistake. I think I think I go through phases of, [00:04:30] of kind of becoming a bit bored, not having enough work to [00:04:35] do. Um, difficult it’s difficult with, with implant dentistry in general practice. [00:04:40] Um or smile makeover type type work that that kind of work. [00:04:45] Um, sometimes in a practice, there might not be enough of those patients to fill a whole [00:04:50] list, right? So it’s quite common to jump around different practices.

Payman Langroudi: So [00:04:55] that’s kind of the reason you do it.

Alex Hadley: Yeah. The by mistake part is, is also is also [00:05:00] true though, because let’s say I get I get kind of, uh, like not not so [00:05:05] busy. Um, have a bit more spare time. Bit almost bored. Yeah. If I could be kind of [00:05:10] sat around a little bit bored. Not not, you know, not, um, not really excited about [00:05:15] the type of work I’m doing then. Then I have had a tendency to take on too many other [00:05:20] jobs all at once, and then I’m a bit stuck and too busy. Um. [00:05:25] It’s quite it’s quite difficult to unwind from an associate job that’s like [00:05:30] what I’ve learned. That’s true. You know, and then. Yeah. And then I. And then I [00:05:35] really worry about, you know, what? What about the the patients who I’ve treated, if [00:05:40] they have a problem making sure they’re looked after. Um, so, yeah, I kind of make [00:05:45] sure like if that if that’s going to happen, there’s, there’s a couple of practices where I’m kind of trying to leave [00:05:50] because they’re a bit too far away. One’s in Colchester. One’s the other side of London, in Feltham. [00:05:55] Um, so do a fair bit of driving. From where do you live? In Essex. Whereabouts? So, [00:06:00] uh, at the moment, Buckhurst Hill. But trying to move to Chelmsford? Oh, yeah. Um, because [00:06:05] my my other half’s a radiologist. She’s got a radiology job in Colchester. So [00:06:10] it’s a bit a bit too far to commute. Did you meet at uni? Uh, we met during [00:06:15] lockdown. After uni? Um, yeah. Yeah, when [00:06:20] you weren’t.

Payman Langroudi: Supposed to be meeting anyone?

Alex Hadley: Um, no no no no no no, it was in. It was in one of those windows where we were allowed [00:06:25] to meet. Meet each other. Yeah. Um, yeah. And we so we actually. Yeah, we actually [00:06:30] met, uh, interestingly, for the first time, um, in [00:06:35] my, I think my second year of uni at a uni night out and there are [00:06:40] photos of us kind of together and then like, we didn’t, we didn’t see each other for five years until [00:06:45] we, we matched on Tinder as is as is like the 2020 way of like meeting [00:06:50] someone and I. And I got penalised actually, because I didn’t remember the first meeting, but obviously [00:06:55] she did. So we know like, you know, women have these like sharp sharp memories this like internal [00:07:00] storage.

Payman Langroudi: So she trained as a medic at Sheffield as well. Yeah. Yeah okay. Yeah. So [00:07:05] look you’re obviously very driven, very passionate. Now it’s very obvious just with a five minute [00:07:10] conversation. It’s very obvious. But were you always.

Alex Hadley: Um.

Payman Langroudi: Yeah. [00:07:15] Did you become that way? Did something trigger it?

Alex Hadley: Uh, [00:07:20] I think as a, as a child, uh, my parents are probably the [00:07:25] main, you know, the main source of that. What do they do? Um, [00:07:30] so they. So dad was a policeman. Mum was a teacher. Um, nobody [00:07:35] in in the family had ever been to university? Um, yeah, I [00:07:40] think I think they, they, they definitely instilled, like, you know, needing to try my best to everything. [00:07:45] Um, which like I think sometimes [00:07:50] I questioned and they would say, I told you so, you know, or because I told [00:07:55] you. Because I told you to do it. You should just do it. Yeah. Trust me, it’ll be. It’ll be better if you just. [00:08:00] If you just crack on. Um, so. Yeah, I think I think I, I’m also [00:08:05] kind of things. Things do come naturally to me I think, which [00:08:10] I’m quite fortunate for.

Payman Langroudi: So were you at school? Were you good at studies. Good at sports, that sort of [00:08:15] thing.

Alex Hadley: Not as good at sports, I would say. But. But like. Yeah, studying like science and maths [00:08:20] from, from quite an early age. Uh, yeah I would my parents made [00:08:25] me do Kumon. Yeah. Yeah, I tried to force.

Payman Langroudi: My kids into.

Alex Hadley: That. Yeah, my my [00:08:30] parents did successfully forced me and my sister into that. And, uh, yeah, I remember [00:08:35] at primary school I would have started and I was, I was like, doing Kumon at lunch or something.

Payman Langroudi: Is [00:08:40] your mum a maths teacher?

Alex Hadley: No, she was a primary school teacher a primary school.

Payman Langroudi: Mhm.

Alex Hadley: Okay. Yeah. [00:08:45] Um.

Payman Langroudi: So why dentistry? How did like how did at what point did dentistry [00:08:50] come up and why.

Alex Hadley: Um so I think my, I think my, [00:08:55] my parents wanted like me to be a professional of some description, [00:09:00] um, like medic, dentist, lawyer, whatever. Like they were they, they, they [00:09:05] really just wanted more for me than they had. Yeah. Um, and they just gave everything to me [00:09:10] and my sister, so we were super lucky. Um, but so, so they they kind [00:09:15] of, um, pushed me to do, like, one of those things. I really don’t like hospitals, so [00:09:20] medicine was, like, out of the question. And although I don’t mind reading, I don’t think I could read [00:09:25] and write all day. Um, so, like being a lawyer, that would be out of the question. Working [00:09:30] in the city, I knew the hours were super long. You know, all these finance guys work super long [00:09:35] hours, hundred hours. I’m although I’m very driven. I don’t necessarily [00:09:40] think I’m like the hardest working. I think I kind of like, you know, I [00:09:45] tend to want to do a bit less.

Payman Langroudi: Work to live, live to work equation. [00:09:50] You know, people go into there’s there’s no right or wrong there. Right? I mean, [00:09:55] dentistry definitely does lend itself to stopping at 530. Yeah. [00:10:00] If you’re an associate.

Alex Hadley: Yeah. So, so so you’re. Yeah.

Payman Langroudi: Certainly not when you become an [00:10:05] owner.

Alex Hadley: No. When, when you, um, you were saying so where did where did the dentistry come from? [00:10:10] Um, I remember they kind of pushed me to do some work experience. And [00:10:15] I went to do some work experience at a general practice like our general practice in Southend. And, [00:10:20] and I remember the dentist, um, great, [00:10:25] great guy, um, probably at the time, like in his 50s, maybe late 50s, 60s [00:10:30] and um, and he was I don’t think I’ve ever seen anybody eat as much [00:10:35] cake and drink as much tea. Right. So he was full time chilling, just like, you know, [00:10:40] exams, small fillings, occasional crown, you know, having a nice time, private practice, den [00:10:45] plan list. Just chill. Um, and like, the only time he got stressed is when [00:10:50] his, his regular nurse wasn’t working with him where like, you know, it made, you know, many didn’t have as many tea breaks. [00:10:55] Yeah. Um, and then I was also very fortunate because we’re, um, [00:11:00] so I, I went to, I think I went to primary school with Paul [00:11:05] Palmer’s son, so like, uh, so he was the year above me at primary school, so we were like five and six or whatever. [00:11:10] Um, and I didn’t know son very well, but, you know, we knew of Paul because because of that. And I [00:11:15] managed to do some work experience at Paul’s. And so in the same week I saw a [00:11:20] man drinking loads of tea, eating loads of cake, and then I watched Paul play ten implants in 2.5 [00:11:25] hours. Wow. So that the patient and the patient paid big money on the way out. Um, [00:11:30] and I think for me, at that point, I realised there’s, there’s got [00:11:35] to be somewhere in between the, the the tea drinking [00:11:40] and doing complex implant surgery where I can probably slot in.

Payman Langroudi: Um, [00:11:45] did you listen to Paul Palmer’s podcast?

Alex Hadley: Yeah, I did. Yeah, I did. Yeah.

Payman Langroudi: Um, [00:11:50] so that was probably a big influence on you. Um, yeah. Because some [00:11:55] look, some people become dentists and don’t ever look at implants at [00:12:00] all. Yeah.

Alex Hadley: I’m, like, scared of them. Yeah. Yeah. A bit.

Payman Langroudi: Like me. I was scared of blood. Really [00:12:05] don’t like blood. Okay. Yeah.

Alex Hadley: You know, I have some nurses here. A bit scared of blood. Yeah.

Payman Langroudi: I’m not scared of blood. It doesn’t make me feel [00:12:10] sick, but I don’t want to be the dentist who cuts. Mhm. Flaps at all, let alone [00:12:15] draw bone. I just don’t don’t want to be that guy. Yeah.

Alex Hadley: I don’t know. I think you get used to that. I’m sure you like. Yeah [00:12:20] I’m sure it’s not for everyone, but I think it’s.

Payman Langroudi: Like endo, you know, you get used to endo. Some people adore it. Yeah. And [00:12:25] then most of us.

Alex Hadley: Not really my thing either. Yeah, yeah, yeah. It’s, um. So why? [00:12:30]

Payman Langroudi: Why Sheffield?

Alex Hadley: Oh. Um.

Payman Langroudi: Because my son’s applying [00:12:35] right now. Oh, yeah. Not to dentistry, revelatory but but applying and Sheffield came [00:12:40] up and said that was Sheffield. And then he went I don’t think I want to spend any time there.

Alex Hadley: Oh, interesting. Yeah. No. [00:12:45] So I did. Um, so I obviously there aren’t that many choices in the UK which [00:12:50] Dental school to choose from. Um, I shortlisted them on, uh, how likely I [00:12:55] was to get in. Um, my GCSE results, although good. Weren’t, you know, [00:13:00] as good as some people applying. Yeah. Um, and so I knew that some, some kind of universities [00:13:05] would have like a big lean towards kind of GCSE results like Birmingham [00:13:10] or King’s or whatever. Like that might be an issue. My Ukcat score also wasn’t very good. [00:13:15] Um, you know, it was kind of above average, but not good. So I looked at all the, all [00:13:20] the, you know, all the universities, like which ones are going to, you know, going to short which ones are going to kind of [00:13:25] am I going to be short changed by applying to. Um, and so I applied to [00:13:30] uh, Barts, Sheffield, um, Cardiff [00:13:35] and Bristol and Bristol rejected me without an interview, which I was a bit annoyed about because it was lovely [00:13:40] and sunny on the day that I went to the open day and had a nice lunch with mum and it was, yeah, lovely, quite [00:13:45] nice. Nice city, like nice old buildings. Yeah. Um. And then, uh. Yeah. Where [00:13:50] else do I look around? I looked around Leeds, but I think it chucked it down with rain when I was looking around, which kind of tainted my, my [00:13:55] opinion of it. Um, and then, and then I got, I got three interviews and three offers from [00:14:00] the other three. Um, and actually, at the time I went on the open day, [00:14:05] Jaz Gulati was the Suds president president. So he just is an [00:14:10] incredible speaker. And he was so passionate about how good his time at Sheffield was that [00:14:15] I thought that I thought, ah, you know, I like this guy like he, you know, he’s got a lot of nice things to say about being [00:14:20] a student here. Yeah. Um, and, yeah, I thought, I thought I could spend some time there. [00:14:25]

Payman Langroudi: Yeah. I listened to a pod today. One of the producer pods. [00:14:30] I’m not even a dentist anymore. Right? Yeah. But it makes it Somehow he makes me want to be a [00:14:35] dentist again.

Alex Hadley: He’s a great guy.

Payman Langroudi: Yeah. Yeah.

Alex Hadley: I occasionally drop him messages about [00:14:40] about things, and I actually have done since that day in probably like 2012. [00:14:45] So for 12 years jazz were like occasionally see a message from me about something or other and it might [00:14:50] be like a podcast or it might be, you know, it might be like the splint course, or it might [00:14:55] be, you know, it might be something or I think I’ve referred a patient to him once as well.

Payman Langroudi: What [00:15:00] were you like as a dental student? Were you top of your class? Were you what were you.

Alex Hadley: Terrible party.

Payman Langroudi: Guy? [00:15:05] Which one were you?

Alex Hadley: Yeah, the latter party guy? Yeah, I think so, yeah. I don’t yeah [00:15:10] there’s that some. Yeah some, some of the, some of the people in my year have probably seen my name on this podcast and [00:15:15] they’ll think, oh Payman is scraping the barrel now. He’s. Yeah. Is that [00:15:20] rude in.

Payman Langroudi: Sheffield where all the bars are King’s Road, it’s not King’s Road, King Street or something. There’s [00:15:25] one road where there’s like. No there’s a.

Alex Hadley: Few. There’s a few. Yeah. Okay. I’m actually going [00:15:30] to Sheffield after this. There’s a beer festival at Kelham Island. Okay. And so I’m still very good friends [00:15:35] with with the guys, the guys who I know from from Sheffield and they live in some of them live in Manchester and [00:15:40] Newcastle. They’re all over. Um, but what did you make.

Payman Langroudi: Of the course? I mean, I remember being just shocked [00:15:45] at the Dental course. Yeah. At the. I didn’t do biology A-level either. Okay. [00:15:50] So that was doubly difficult. Yeah. I just remember thinking, bloody [00:15:55] hell, this is serious, man.

Alex Hadley: I tried, I tried really hard for about six months. [00:16:00] Maybe not even six months. Um, maybe like the first 3 or 4 months. [00:16:05] I remember in first year, I, you know, I tried to study and whatever. And then [00:16:10] I thought with the, the vision being, oh, if I get honours in like [00:16:15] one exam a year, then you know, that that would be that was my idea of like a successful [00:16:20] like dental school career. And I think I worked really hard. I didn’t [00:16:25] have enough smarts to kind of seek out the, uh, like, the past paper questions. [00:16:30] You know, the question bank, which is invaluable. Like nobody. Obviously, nobody’s getting on [00:16:35] us without the without the question bank. So I got 64% in the [00:16:40] first exam, which was 1% shy of the like the honours mark. Mhm. [00:16:45] And at that point I thought I’ll throw the towel in now and, and. Yeah. And go [00:16:50] to the pub. Yeah. So that’s what I was doing. Yeah. Ten. Well 12 years ago I guess.

Payman Langroudi: And then [00:16:55] the clinical side.

Alex Hadley: So I was um I didn’t take to that particularly well either. I’m a bit, [00:17:00] uh, a bit of a perfectionist with like the well, with, with, [00:17:05] you know, practical things that I’m doing. So I mean, it doesn’t necessarily have to be dentistry, but obviously now [00:17:10] it is. It’s all dentistry. Um, yeah. I almost [00:17:15] when when we started treating patients, I felt like I was doing them a bit of a disservice because [00:17:20] I, I felt like they would be better served seeing someone else, you know, if they [00:17:25] saw, you know, a dentist who’d done thousands of fillings, then obviously they beginning.

Payman Langroudi: We all feel that way, right? Yeah. [00:17:30]

Alex Hadley: Yeah. So I remember yeah, my first couple of fillings were on my best mate and [00:17:35] they’re still there. I think, I think, I think good, good. Um, yeah. [00:17:40]

Payman Langroudi: So then you you saw Paul Palmer very early on? [00:17:45] Yeah. Throughout dental school. Was it already in your head that you would. You would be [00:17:50] placing implants and implantology was something you were going to look at? Are you tactical [00:17:55] in that sense? Are you the kind of person who thinks because the acceleration’s admirable. Yeah. [00:18:00] Like, you know, in in 5 or 6 years, you’re you’re doing a lot of work that a lot of [00:18:05] people don’t even think about starting to do.

Alex Hadley: Yeah. No, I didn’t I didn’t have that in mind. Did [00:18:10] you. No, not at all. No, I was no, I, um, I thought about kind of finishing the course, and I [00:18:15] was a bit disillusioned with dental school in third year. You know, I didn’t. I didn’t fancy it. [00:18:20]

Payman Langroudi: Um, so what about your first job? Who was your first boss? Was it your first boss in Sheffield? [00:18:25]

Alex Hadley: Yeah. Uh, a guy called Randeep, Randeep Chung who I’m hopefully going to see this weekend. I haven’t seen [00:18:30] him for ages. Amazing. Um, very cool guy. Yeah. So, um, couple. He’s got a couple of practices [00:18:35] now. Like big, big kind of mixed practices. Um, yeah, [00:18:40] I think, um, he, I would, I would, uh, go into work thinking [00:18:45] we would be talking about, uh, you know, I might want to talk to him about this case that I’m doing. You know, maybe it’s like a bit of tooth wear or [00:18:50] something that makes it tricky. And he had a he had a or has a, uh, a [00:18:55] diploma in restorative dentistry from. I think it’s RCS as well. So he’s quite [00:19:00] clued up on, you know, doing, doing some nice work and does really, really cool, um, [00:19:05] composite build ups like direct build ups. Some of the patients around there, you know, finance, [00:19:10] finances, don’t allow them to have like, you know, really expensive makeovers and whatnot. Um, [00:19:15] but he’s doing a lot of bonding, and the bonding is really good. It’s a shame. It’s not like he’s not marketing composite [00:19:20] veneers. He should be. Yeah. Um, I might have to have a chat with him. Um, but. Yeah, So [00:19:25] I would I would go up to him and and show him, you know, all this, this case that, that I wanted to discuss. [00:19:30]

Alex Hadley: And he would, um, he would often show me he’d be like, [00:19:35] okay, cool. Alex. Cool, cool. Um, look at this video. This is me and my motorbike at the weekend at [00:19:40] Donnington, doing 150 miles an hour on on his Fireblade. Or at the same [00:19:45] time he was learning to, uh, he was learning to fly a helicopter. So now he’s got helicopter people. So [00:19:50] then like the following week, I do the same thing again. Like, try and show him this. Show him a case. He’d be like, yeah, yeah, yeah, that’s [00:19:55] cool. Alex. And then like, show me a video of a helicopter. So, um. Yeah. Nice. So that [00:20:00] that that was kind of a nice influence. Yeah. Like a non. Yeah. Non. Dental. Um, [00:20:05] yeah. Think, I mean he’s, he does cool stuff now like, um I [00:20:10] think he recently. So he does like the Dakar uh, rally. Rally. Yeah. Well no, no. Well [00:20:15] he did the original para Dakar route on a, on a bike. So you know there’s some [00:20:20] guys like they put, they put their bikes in a container and yeah. Yeah yeah. So he does all stuff like that. [00:20:25] So. Very. Yeah. Very interesting bloke. Um, did you stay there.

Payman Langroudi: Longer than the one [00:20:30] year or.

Alex Hadley: No, I think because I, we discussed that I’m a little bit lazy. I, um, I [00:20:35] took a few. I took a few sick days, uh, during PhD. Um, [00:20:40] yeah. Kind of like, kind of like at university as well, I guess. Um, and [00:20:45] yeah, his, his wife is the practice manager. I think she just thought I was a bit of a nightmare. Um, we’re quite friendly [00:20:50] now. No, I don’t work for them. But then I think, um, as soon as, [00:20:55] um, as then, then I worked in, uh, Retford in a, uh, [00:21:00] in an NHS practice, like most of the NHS practice, I’ve got friends who work in that practice [00:21:05] now actually, and they’ve done a bit of a private conversion on it. Principle’s really quite impressive as well. [00:21:10] Um, huge NHS contract, like 35,000 udas at [00:21:15] quite a high rate as well. I think, you know, they’re, you know, they’re bringing a lot of, a lot of NHS patients [00:21:20] in serving quite, you know, a huge swathes of the population out there. This is like Nottinghamshire. [00:21:25] Mhm. Um, and the principal’s doing some Invisalign and whatnot. Um but then, [00:21:30] then that was, that was, you know the lead up to lockdown.

Alex Hadley: So lockdown, [00:21:35] you know I had this NHS contract which was quite, quite cushty. Uh principal [00:21:40] was really nice. Yeah. He had a big NHS, NHS contract so I think I think yeah one [00:21:45] day I got, I got paid to go in. I think I told you about this. I think I got [00:21:50] paid to go in uh, to take one tooth out on one day for like my whole NHS contract [00:21:55] value for that week, which is still just the, you know, ludicrous. Um, [00:22:00] and then the rest of the time, it was quite a nice summer, actually. The rest of the time was just in, in Sheffield. [00:22:05] Um, in the sun, in the, you know, in parks and whatnot. Um, and then [00:22:10] and then made the decision to move, to move back to Essex more so [00:22:15] to pursue some private dentistry. I just knew that, you know, the the market [00:22:20] down here is much, much better for doing that. You know, doing doing higher [00:22:25] end work where I could probably, you know, do less work, [00:22:30] um, at a higher standard, a higher standard and you know, and be rewarded better [00:22:35] for it. So yeah. Yeah. Well, you know the.

Payman Langroudi: Rewarded better piece per [00:22:40] unit of course.

Alex Hadley: But yeah. But also but also like find it more rewarding. Yeah yeah.

Payman Langroudi: Yeah [00:22:45] yeah. No no. But let’s talk about the actual financial reward. Yeah. Oh yeah. That per unit you’re going to make more [00:22:50] privately. Yeah. But this, this guy you’re talking about with the high UDA value. Yeah. [00:22:55] Big number of patients doing a couple of Invisalign. That’s a cash [00:23:00] cow. Yeah. That’s a gigantic business for for one practice. Yeah. [00:23:05] For one.

Alex Hadley: Guy. For one.

Payman Langroudi: Guy. Yeah. Yeah.

Alex Hadley: And so I think now he’s, I think they’re now they’re like 9 or 10 surgeries now. [00:23:10] Wow. And he uses two therapists to do his NHS contract. So he’s doing like 12 [00:23:15] 15,000 udas himself through two therapists.

Payman Langroudi: But what I’m saying is at a higher [00:23:20] rate. Yeah. Yeah. The associate part of that deal is amazing for the [00:23:25] principle. Yeah.

Alex Hadley: Yeah. The associates I mean, I don’t know what it’s like now, but I mean, I was, I [00:23:30] was being paid £11 a UDA. I think it’s UDA. It’s probably 30, £35 or something. [00:23:35] Yeah. I mean so, so yeah. So every, every every check up. He’s getting paid more than me. Yeah. Way [00:23:40] more. Yeah yeah.

Payman Langroudi: Yeah. And in effect, he’s on, like, a 70 over 30 deal with you.

Alex Hadley: Yeah yeah yeah yeah [00:23:45] yeah yeah. Which I, which I knew about and I was a bit disillusioned by. But then, but then I was, I [00:23:50] was treated very well during like when there, when there was no work and you know I had some, I had some mates who worked [00:23:55] at private practices where they were, they were owed, they were owed money for work [00:24:00] done, work that had been completed. And then their principles kept it. Yeah. [00:24:05] And then they, I can imagine, fell out with them and then didn’t have any work. So. [00:24:10]

Payman Langroudi: Yeah. And, you know, my wife’s a private dentist. Uh, [00:24:15] Associate and zero throughout lockdown and [00:24:20] okay, we were okay. But I often think about what if you were a [00:24:25] single mum? Yeah. And, you know, a single mum putting two kids through school or whatever. Yeah, generally there [00:24:30] isn’t huge savings when that’s happening.

Alex Hadley: And I wonder.

Payman Langroudi: What happens to you.

Alex Hadley: Yeah. I wonder where income [00:24:35] protection comes into that. Like, you know, even then it’s going to be like, did it not I’m not sure maybe. [00:24:40] Yeah, I don’t know.

Payman Langroudi: Enlighten. You know, the day before lockdown it was shut down. You [00:24:45] know, I think we brought in that day £25,000 the day after zero. Yeah. [00:24:50] And then 000000 and way before they even mentioned the word [00:24:55] furlough or, you know, that 80% thing paying. Yeah. Yeah, yeah. We talk to our [00:25:00] team and said we have to lose half of you. Yeah. You know overnight. Yeah. Um, but it’s interesting [00:25:05] that different people have different things out of it. Yeah, yeah. So then this thing you’re saying about [00:25:10] you knew down south there’d be more scope for private. Yeah. I [00:25:15] suspect nowadays your peers, people who you qualified with, [00:25:20] almost everyone’s trying to get to private dentistry. Is that right? Yeah. Yeah. [00:25:25]

Alex Hadley: Because everyone in.

Payman Langroudi: My day, that really wasn’t a thing. But now it really has become that [00:25:30] way. Yeah. And so the competition [00:25:35] to get a private job. Yeah. Was, is that being part of the driver [00:25:40] to make yourself more employable, go on courses?

Alex Hadley: I don’t know. I think, um, [00:25:45] did you find it easy to find a job? Yeah. Yeah. Yeah. Well, I mean, yeah, you make [00:25:50] your own luck, right? So, I mean, I think what I did when I was in, when I was in, uh, in Sheffield, [00:25:55] I messaged Amit Patel, Essex dentist. Yeah. Amit Patel, a [00:26:00] guy in Brickfields. Okay. Tk and Amit. Um, and I, there’s [00:26:05] quite a few. Amit Patel has got to be quite, quite specific. There’s a few Ash Palmer’s a few few. There’s a few of them. Um, [00:26:10] so so uh. Yeah. Messaged Amit and, uh, he [00:26:15] was he was hiring for Brickfields, which is obviously a mixed job, but heavy, heavy private [00:26:20] mixed job. Yeah. Good practice, which is what I was, what I was after. So went to interview [00:26:25] at Amit’s. I think he had 60 applications for this one associate job. Uh, [00:26:30] did you know interviewed? No. Didn’t know him. Are you cold email? Yeah. Just like, uh. I don’t [00:26:35] think I emailed him. I think I messaged him on Instagram and he. Yeah, I went down for [00:26:40] a weekend, went to see my parents and then, you know, went to Brickfields and had a chat with him. Um, [00:26:45] and then he didn’t give me an associate job. But this was what for? For [00:26:50] nearly five years ago, he didn’t give me an associate job, but he passed my details [00:26:55] to dev. Dev. And that’s when. And that’s when. Because they’re good mates. Yeah, yeah. And then dev. [00:27:00] Yeah. Dev phoned me, um, and I was, I was out working in Retford, um, [00:27:05] and, and you know, they sold me the, the mixed practice Dental [00:27:10] beauty Romford kind of associate job. And yeah, [00:27:15] at that point in time, I think that was the third practice that they’d purchased. So it was the [00:27:20] third one and now they’re on like 45 odd. Yeah. [00:27:25] So I’ve kind of seen Dental beauty from.

Payman Langroudi: So we should, we should, we should say Dev Patel. We’ve had twice on [00:27:30] this podcast. Yeah. But the guy who started Dental beauty and they go they go into sort of 51, [00:27:35] 49 partnerships with principals. Yeah. And Amit was [00:27:40] his buddy.

Alex Hadley: Amit is just. Yeah. They’re just buddies. Yeah, yeah, yeah. Um, and.

Payman Langroudi: And Paul Palmer, [00:27:45] was he a professor in? Not.

Alex Hadley: I don’t think Paul’s prof. I think he Paul’s older [00:27:50] brother. Paul’s older brother was professor. Yeah. Um, yeah. Paul. Paul was very [00:27:55] kind, um, in, like, trying to help me get into dental school. I haven’t seen I haven’t seen [00:28:00] much of him. Um, yeah. Occasionally I send him pictures of implants. Like, you know what? [00:28:05] You know, x rays. Like, do you know what this is? He’s like very, very [00:28:10] kind, sometimes telling me what they are. Um, but I haven’t seen him very much. So now you’ve.

Payman Langroudi: Started [00:28:15] in Dental beauty, which is. It’s private, isn’t it? It’s not, it’s not.

Alex Hadley: It’s [00:28:20] mixed. It’s mixed. It’s mixed. But, um, it’s what, in the olden days we.

Payman Langroudi: Would call independent practice. [00:28:25] It’s kind of. Yeah.

Alex Hadley: There’s. So I think when I, when I joined, they [00:28:30] effectively wanted me to do no udas or, you know, the, the, um, [00:28:35] the premise being using the NHS list as a springboard to provide, [00:28:40] you know, private, private work. Yeah. Which was nice, um, you know, learned [00:28:45] to take photos and, you know, all, all manner of, you know, other private [00:28:50] treatments, but also mainly, mainly kind of communicating with patients, having a bit more time to do [00:28:55] that. Yeah. Um, I think the communication thing is quite is innate, right. I think most, [00:29:00] you know, most good communicators like yourself have probably always been a good communicator. [00:29:05] Um, And so yeah, I think it was nice to have it was nice to have some more [00:29:10] time to spend with patients, to get to know them, to build rapport, um, [00:29:15] and also to provide them with better treatment. So I think, yeah, [00:29:20] I, you know, lots of lots of associates are especially within corporates [00:29:25] can be a bit, um, I don’t know, uh, they probably hold back and, you [00:29:30] know, they’re not not, um, not huge fans of the corporate model. Um, but [00:29:35] I do. Yeah. Have to give Will and dev, you know, some, um, some some respect [00:29:40] for it. It’s, you know, they they definitely provided me with a platform where I [00:29:45] could kind of progress and do more complex work. I [00:29:50] even, even now don’t have an issue with getting materials [00:29:55] in or if I need a particular drill or, you know, stuff [00:30:00] that you need for implants. Obviously, all of it’s really expensive. Um, fixture removal kit [00:30:05] £1,500. You know, Will’s on holiday, like. Yeah, he’s [00:30:10] okayed it from Cape Town, I think. Um, so. Yeah, it’s nice. It’s [00:30:15] nice having, like, it being a small corporate. Obviously things have changed in the three, [00:30:20] 3 to 5 years that I’ve been.

Payman Langroudi: There for the company.

Alex Hadley: Right. For the company. Yeah. And for the [00:30:25] staff, I guess. Yeah. I think things have changed a bit on how. Oh, [00:30:30] um.

Payman Langroudi: Have they got few more procedures [00:30:35] and sort of.

Alex Hadley: Yeah. There are, yeah. There is like. Yeah, there’s definitely a little [00:30:40] bit more, uh, compliance focus, which you would expect. Yeah. [00:30:45] Um, yeah. There are more systems. And the I think as the [00:30:50] practices become established, the, the partner or principal can be kind of more hands off. Mhm. [00:30:55] Which is the, the objective. You know they’re kind of leveraging their time. That’s like the, the main [00:31:00] benefit to them. Um Yeah, I think I’m [00:31:05] not sure. I’m not sure kind of what else has what else has changed? [00:31:10] I think I think that’s probably that’s probably the most [00:31:15] notable thing. Like on the plus.

Payman Langroudi: Side, I mean, have they learned marketing better? Are you getting patients more [00:31:20] than you were three years ago? 4 or 5 years, I.

Alex Hadley: Think I am, but I’m not sure that’s that’s just I’m not sure that’s [00:31:25] marketing. Yeah. I think in fairness, we do get I get internal referrals from, uh, some [00:31:30] of Will’s other practices, which is really nice. Um, but yeah, I think implant dentistry [00:31:35] just selects for, you know, you to, to to get referrals or. Um, [00:31:40] yeah, it kind of selects for bigger cases generally because the patients [00:31:45] know that they’re expensive and they know that they’re, they’re kind of pre-qualified themselves. Yeah. For that. You haven’t learned. [00:31:50]

Payman Langroudi: Anything implant wise at the beginning of your. No. So when when did the implants come in. At what. [00:31:55]

Alex Hadley: Point. Well so that’s another that’s another DB thing. So Sanjay Sethi was uh, we were [00:32:00] referring implants to Sanj. Sanj was restoring implants in house and he [00:32:05] taught us how to restore implants.

Payman Langroudi: So he was actually visiting dentist?

Alex Hadley: Yeah, [00:32:10] but only I think he only came a few times, but, um, he came to [00:32:15] give a talk, um, in one of the surgeries, um, [00:32:20] after it was like after work on how to restore Sweden and Martina Prama [00:32:25] implants and Tommy from Sweden. Martina. He came along, um, and. [00:32:30] Yeah, like Sanj gave gave us, like, the, you know, the rundown on what to do, how to [00:32:35] do it. And then also had, uh, had a patient who Will had referred to him, um, [00:32:40] that we we well, I restored with Sanj. So the last [00:32:45] patient of the day, you know, like 5:00 till half five or whatever, um, which was [00:32:50] nice. Yeah. Like so, so, like practical.

Payman Langroudi: Side [00:32:55] of implants.

Alex Hadley: That way. And then sent some implants to Sanjay. And then I was doing, [00:33:00] then I’d done Ash’s course and I was doing more Ash Palmer and I’d done [00:33:05] I had I had I’d started doing more smile makeover stuff and I’d come across other implant brands, [00:33:10] you know, or other implants that had been placed in spaces that I wanted to [00:33:15] use. So then I was I was restoring implants in smile makeovers. [00:33:20] Yeah. Um, you know, learning about angled screws and, you [00:33:25] know, what needed to be cement retained or, you know, how how best to, um, you know, sound covered, [00:33:30] like all the all the good stuff on occlusion and, um, yeah, [00:33:35] I and I, I, um, so I was restoring them pretty routinely [00:33:40] and then I thought, oh, I would quite like to. I was seeing quadrants because I still do. [00:33:45] You know, I’m a general. I’m just a general dentist. Right. So I see some quadrants with spaces and think it’s [00:33:50] like it would be great to put an implant in there.

Payman Langroudi: So before we move on to the placement, um, [00:33:55] you know, learning about placement, What’s the crux of restoring implants? Like what’s [00:34:00] what’s an aha moment? What is someone who doesn’t do it right now and they want they want to do it. [00:34:05] What are the things that surprised you or.

Alex Hadley: Surprised me about restoring [00:34:10] implants?

Payman Langroudi: Things that you learned or key? Key aha moments for you? I mean, what’s the difference? [00:34:15] Okay. There’s the.

Alex Hadley: Impression. I mean, it’s. Nuts and bolts. Yeah. It’s not. It’s not rocket science. I think everyone’s terrified about [00:34:20] it. It’s, um. No, as long as. As long.

Payman Langroudi: As you don’t be scared of.

Alex Hadley: It. I don’t know. Well, Sanj Sanj [00:34:25] explained it very well, and he said, does anyone want to have a go? And I said, yeah, I’ll. Yeah, fine. And [00:34:30] it’s only, you know, it’s it’s they’re only screwdrivers and tiny screws. Just don’t drop them. That’s [00:34:35] it. Just don’t drop the screws. Yeah. Or make sure you got some spare screws. It’s handy. Spare ones [00:34:40] are good. They’re quite tricky to find. Um, yeah, I don’t know. Restore restoring implants. [00:34:45] Fairly straightforward. Um, making implants look like teeth. [00:34:50] Very different story.

Payman Langroudi: As in the gingival?

Alex Hadley: Yeah. The stuff you’ve seen, [00:34:55] the stuff you’ve seen at Bard like the. Yeah, the the connective tissue graft and [00:35:00] the depth of placement. Um, yeah. I think making implants [00:35:05] look good is an awful lot in the, in the surgery. Um, and.

Payman Langroudi: You know, I’m quite interested in this [00:35:10] idea of, you know, the planning, being from the restorative dentist. Sort of. I [00:35:15] want the tooth here. Mhm. And then that being sent to the [00:35:20] if you’re, if you’re referring. Yeah. That being sent to the implant ologist. Yeah. [00:35:25]

Alex Hadley: Well fortunately yeah.

Payman Langroudi: Between you and the implant ologist as the referring dentist it [00:35:30] should be the referring dentist saying where they would like the end result to be the angulations and so forth, [00:35:35] and then for the implant ologist to sort of translate that to the operation in a way.

Alex Hadley: So, so fortunately, [00:35:40] I think this is this is a good reason why some of the best implant guys [00:35:45] are not specialist oral surgeons, right? They’re Sanjay [00:35:50] Restorative, Robert Shetty, you know, these are these are guys with BDS. [00:35:55] They’re not specialists and their work is beautiful. Um, so that’s I [00:36:00] think that’s the objective. That’s like that’s that’s what you can be a specialist.

Payman Langroudi: Prosthodontist. Right.

Alex Hadley: You [00:36:05] can. Yeah, you can be.

Payman Langroudi: That could be a good starting point.

Alex Hadley: You can, you can be. That’d be. Yeah, that’d be a great that’d be a great [00:36:10] starting point. But then, you know, there’s no you know, there’s no reason why you, why anyone [00:36:15] couldn’t do that work without being a specialist. Prosthodontist. Of course it’s, it’s yeah, [00:36:20] it’s a different model now I think. Yeah. Maybe. I actually do remember [00:36:25] having a chat with Paul about specialist lists. Um, because I know, I know [00:36:30] those. I know he was involved in the, the creation of specialist lists. Right. [00:36:35] Um, and I did I did ask him, like, you know, do you think it would be worth doing it [00:36:40] now? And this was five years ago when I graduated six years ago. Um, and [00:36:45] he said, yeah. He was like, yeah, the the punters don’t really [00:36:50] know the Difference. Um. And I’m not sure. I’m not sure it would be [00:36:55] worth it. You know, it’s like you’re not sure it’d be worth your time to go back to uni, take a huge pay cut. [00:37:00] You know, you get this training number. You you may or may not become a specialist on a specialist [00:37:05] list. And then, you know, at the end you’re competing with everyone anyway because everyone’s [00:37:10] marketing the same, the same work. Um, so yeah, I think that the practice model has changed, certainly with, [00:37:15] with keeping keeping all the specialities in-house, even if it’s dentists with special [00:37:20] interests. Um, which I think it probably makes it difficult as a patient to choose [00:37:25] who who to trust. Yeah.

Payman Langroudi: Um, it’s the specialist thing is [00:37:30] interesting because, like, if someone said to me, should I go and specialise [00:37:35] in fixed pros, um, or should I do the whole choice [00:37:40] continuum? Maybe you could, in the same time and money that it takes you to do [00:37:45] a proper speciality training. You could do a whole lot of.

Alex Hadley: Other.

Payman Langroudi: Training.

Alex Hadley: Yeah. [00:37:50] I mean, I’ve spoken to, uh, I’ve spoken to a friend of mine, a very good friend of mine, uh, periodontist [00:37:55] about his perio training at Kings. And he said, yeah, they place like 20 implants [00:38:00] in a few years. Yeah. Well, I was like, you know, I placed a couple hundred [00:38:05] in a couple of years, so, like, you know who who learns more about implants? You [00:38:10] know, the guy who’s placing more or the, you know, or the specialist who’s having, like, really [00:38:15] good teaching. The benefit is really good teaching, you know, really good specialist [00:38:20] level teaching about a treatment modality. Um, the drawback is there’s, [00:38:25] you know, you’re not actually doing that much hands on work. So and in a job which is mostly [00:38:30] practical, the hands on work, the ability to, to learn new things [00:38:35] as you go is I think.

Payman Langroudi: It’s a hands on job. It’s a hands on job, there’s no [00:38:40] doubt about that. Um, we mustn’t underplay, you know what else you get from a [00:38:45] specialist training, right? Yeah. The critical thinking part of it. Yeah. Um. The [00:38:50] contacts? Yeah. I mean, you know, you’ve got a few contacts. You had a few contacts. Yeah. [00:38:55] I would consider some people don’t have those. Yeah.

Alex Hadley: I would consider my, you know, my non-specialist [00:39:00] contacts, like, as good. You know, these are, these are guys working to specialist level doing, [00:39:05] you know, whatever they’re doing, you know, Rob and Sanj to help, help problem [00:39:10] solve. That’s you know, I think actually you hit the nail on the head there. It’s clinical. It’s just problem [00:39:15] solving. It doesn’t matter whether you’re a specialist or not. Um. Yeah. The ability [00:39:20] to fix your own problems is super important.

Payman Langroudi: And Rob Moretti, how did you [00:39:25] come across him? But how did you come across Bard? Sanjay.

Alex Hadley: Sanjay. Sanjay and Nick. [00:39:30] Yeah. It’s funny. He dragged me there. Yeah. Yeah, yeah. They said you should. You should. You’ll really like it. You should come.

Payman Langroudi: And you [00:39:35] know, that’s how. That’s how we met. Like, it’s an interesting thing, right? Because if if Sanjay Sethi [00:39:40] wasn’t the implant ologist at Dental beauty.

Alex Hadley: That if I hadn’t messaged Amit. Amit hadn’t put [00:39:45] me in touch with dev. Dev wouldn’t have like, you know, got me in the practice stage. I [00:39:50] wouldn’t have met Sanjay. I wouldn’t have met Nick, and it wouldn’t have gone to bad, you know.

Payman Langroudi: And it goes to show, you probably know the other [00:39:55] Payman, the beautiful Payman. Payman.

Alex Hadley: Yeah, he’s a good guy. He’s also [00:40:00] DB.

Payman Langroudi: He’s also Dental.

Alex Hadley: Beauty, also a bard. I met him at Bard first.

Payman Langroudi: Yeah, well, he told me his brother’s [00:40:05] practice. I don’t know if you’ve ever seen that one. No, it’s a stunner. Okay, it’s a stunner. It really is [00:40:10] beautiful. Um, actually, they moved, and now it’s. I think it’s not as stunning as it was, but. But it [00:40:15] was a stunner. Yeah. Um, very successful practice. He said the whole practice, [00:40:20] beginning to end, was dependent on one patient. And I was like, how could that be? And [00:40:25] he said, yeah, it was this one Qatari guy who came in. He had toothache. Yeah. They [00:40:30] if I remember, I can’t remember the story exactly, but he he excavated the pulp and [00:40:35] the guy said, how much? And he said nothing. He said, just come back in for an examination [00:40:40] that that connection, they got him the Qatari embassy and all that. Now they’ve got [00:40:45] a point where they go to Qatar and treat the royal family. Yeah. Cool. Yeah. Because of that one? [00:40:50]

Alex Hadley: Yeah. Just one interaction. Yeah. It’s almost like a cascade of. Yeah.

Payman Langroudi: But it goes to show you don’t know which one [00:40:55] of the interactions of the hundreds that you have is the one that’s going to [00:41:00] be one of those. Yeah. And so important isn’t it. Like me and you meet [00:41:05] over a coffee over in Bard. Yeah. Being, being being humble in all of those [00:41:10] interactions, or being a good person in all those interactions can lead to so many different things. [00:41:15] Yeah. And it’s a good lesson. Although personally, I’m very shy, you know. So if I go into [00:41:20] a room where I don’t know people, generally I won’t approach people. Right. Um, so, [00:41:25] you know, it’s something I could get over. Yeah. So some people are shy and some people are very forward. Right.

Alex Hadley: Have you done a [00:41:30] personality test?

Payman Langroudi: No. I just know I’m shy.

Alex Hadley: Yeah. You should do, like, one of the big five [00:41:35] traits.

Payman Langroudi: No, I have. Of course, of.

Alex Hadley: Course, I’ve done a few of those. I was gonna say. Yeah. Yeah. They’re interesting. Yeah. I’m about. I [00:41:40] think I’m about as extroverted as you. Yeah. Like the 98%. Yeah. [00:41:45]

Payman Langroudi: Yeah. Which one? Which one was your favourite personality?

Alex Hadley: The Jordan Peterson. Understand myself? [00:41:50] Oh, really? That’s a really I’ve done that a couple of times because I actually a couple of times like a few years apart. [00:41:55] Um, and I wondered whether they, whether those, those traits had changed, [00:42:00] like, whether, you know, has like my environment changed how I would answer those questions [00:42:05] in a few years. It’s basically exactly the same. So, so.

Payman Langroudi: Human interaction feeds you.

Alex Hadley: Yeah. [00:42:10] Yeah. Like, if I spend too much time on my own, I’m like, [00:42:15] I get a bit edgy. Yeah. Really need to go and talk to people. [00:42:20] It doesn’t really matter what I’m talking to them about or who they are. Which which. I mean, it’s [00:42:25] kind of like at work. I know, I know, I, I know I’ve met a lot of dentists who are really introverted. [00:42:30] Um, who it almost like saps the energy out of them. Yeah, yeah. Like [00:42:35] talking to people at work, you know, by the end of the day, they’re they’re, you know, they’re they’re completely [00:42:40] toast. I’m toast. But it’s because I’ve been thinking too much. I’ve been talking too much. [00:42:45] Um.

Payman Langroudi: Look, private industry is important to really connect [00:42:50] to each patient. I mean, it’s very important. Yeah.

Alex Hadley: Eight facts. [00:42:55] Sorry. Eight. Eight facts. Yeah. You should try and gather. Oh, is that right? Eight [00:43:00] pieces of information. This is. This is Ash Palmer gem. Oh, really? Really. Ash Palmer gem. Yeah. Facts. Before [00:43:05] you go. Eight facts. Yeah. So, uh, you’re asking the patient. Yeah, asking [00:43:10] the patient, like all. So he pretty much standardises, like, all the, um, like the questions [00:43:15] that he asks because it’s easier for the teacher to teach us. So, um, you know, [00:43:20] uh, have you been here before? Are you local? Um. So are you local? [00:43:25] Leads to, like. Oh, where do you live? Who do you live with? Do you have any children? Do you have any pets? Uh, [00:43:30] what do you do for fun? Um, those all those questions. You can ask those questions to anyone? [00:43:35] Yeah. Um, and then make sure they’re recorded the answers to those questions [00:43:40] because as a clinician, you will forget what the answers are. Okay. But the patient won’t forget that you ask them, [00:43:45] so they’ll think and then.

Payman Langroudi: Refer back to those.

Alex Hadley: Yeah. Yeah I mean yeah ash does. Yeah. [00:43:50] Particularly in like proposing treatment plans and whatnot. Um, he wouldn’t necessarily refer [00:43:55] back to them, but it’d be it’d be a reminder of kind of who the who that person is. Yeah, [00:44:00] yeah.

Payman Langroudi: And what I was going to say was in private dentistry, those conversations are absolutely [00:44:05] key. Yeah. Absolutely key. I mean, you know, whether or not someone [00:44:10] recommends you to a friend has more to do with whether [00:44:15] they like you.

Alex Hadley: Yeah. Than the work they say you’ve got you. There are three, [00:44:20] three things, right. It’s like you you either say there are three three [00:44:25] categories. Like the first is the patient likes you. Yeah. Uh, the second is doing the right treatment and [00:44:30] the third is doing the treatment. Well, it’s like you need two of those three. Yeah. I [00:44:35] like the ability to fall back on the patient liking me. Yeah. Because I’m sure at some point, you [00:44:40] know, there’ll be some. One of the others will, will will fall back. Yeah. Because, you know, you can you can be like a real, [00:44:45] you know, hard, hard dentist, like, you know, you know, kind of, uh, [00:44:50] not particularly friendly with patients, but you’re going to have to do the right treatment and do the treatment. Well, every [00:44:55] time, like, every single time. Um, but, you know.

Payman Langroudi: The other thing, I mean, the patient has no idea [00:45:00] what’s really going on in his mouth. Yeah. I mean.

Alex Hadley: Until you put the photos on the TV. [00:45:05] Well, and then they’re like, you’re horrified.

Payman Langroudi: You don’t have to put the photo. But but we all know there’s there’s [00:45:10] there’s many things you do that no one will ever know that you did. Yeah. The [00:45:15] the the way you put that particular matrix on. Yeah. You know what I mean? [00:45:20] I mean, all the way to just all the occlusal checks that you do. Excursions. Yeah. You [00:45:25] know, the patient has no idea how much care you are or [00:45:30] aren’t taking. They can get a feeling for it.

Alex Hadley: They definitely get a feeling.

Payman Langroudi: Get a feeling for it. But liking you. [00:45:35] Super important and having the time and being listened to and all of that sort of [00:45:40] stuff super important, especially if, you know, the patient used to be NHS [00:45:45] and was sick of not being talked to, sick of being seen late, sick of not [00:45:50] being listened to. Yeah. And I often feel that feeling if I go to the GP, [00:45:55] um, to the point that I’m looking for a private GP. Yeah, that he’s always 45 [00:46:00] minutes late. Always. Yeah, they might as well just tell me 45 minutes after they tell me. [00:46:05] Yeah, yeah.

Alex Hadley: And then I’m quite bad for running late. Incorrect. But not but [00:46:10] not incorrect. But not really. Not but not not not. Yeah. Not really bad. But you know, occasionally.

Payman Langroudi: I think [00:46:15] my GP is great. He’s a good guy like him. Yeah. He’s got no time man. Yeah. He doesn’t [00:46:20] even look up.

Alex Hadley: Yeah. 45.

Payman Langroudi: He asks questions. He asks questions and he’s typing. [00:46:25] Yeah. The whole time he’s he doesn’t look up.

Alex Hadley: Yeah. That’s that’s one of the worst things we can do I think you know the, the [00:46:30] typing the notes while the patient comes in. Yeah. So no, always go get your own patient. [00:46:35] Yeah. Always patient. They feel like you’ve taken the time. I mean, even if it takes 20s [00:46:40] one of those things.

Payman Langroudi: About the, you know, training your nurse thing. Yeah. Um, training your [00:46:45] nurse to write the notes. Yeah. Yeah. Is super good idea. Yeah. Until, [00:46:50] of course, you have to, you know, adjust them or whatever. Um, we were talking [00:46:55] about Kalish. Was that before we turned on the.

Alex Hadley: Yeah. Before we turned on. Yeah.

Payman Langroudi: He uses two.

Alex Hadley: Nurses. [00:47:00] Yeah.

Payman Langroudi: Yeah. And and, you know, his his hourly rate is [00:47:05] unbelievable. Yeah. Yeah. And when you realise that, you realise that the hourly [00:47:10] rate is through the roof. Because. Partly because. Yeah, there’s two nurses taking [00:47:15] care of everything, you know.

Alex Hadley: Yeah. Yeah yeah, yeah. I mean, yeah I could, I often make use of two [00:47:20] nurses, like with on an implant day. Like if I’ve got a couple of nurses then, you know, they’re, [00:47:25] they’re sometimes I always joke that they got unlucky that day. Yeah.

Payman Langroudi: Let’s continue. [00:47:30] So let’s continue with you then. Decided I wouldn’t mind sticking some of these implants in. So what [00:47:35] do you do next?

Alex Hadley: Um, I did the smile Dental Academy Pgdip. [00:47:40] Why do you pick that one? Sanj sanj Sanj recommended that I do. I think [00:47:45] he knew Rob and Martin were teaching on it, and, uh. [00:47:50] Yeah, I don’t know if he knew. I don’t know if he knows. Um, I think they I think they know each other, [00:47:55] but, um. No, I think he was more recommending the, um, the, the, the teaching [00:48:00] on the day, you know, with, you know, knows the guys quite well. Um, and [00:48:05] I was looking for one in London that started like, you know, soon. Yeah. Kind of because it’s going to take [00:48:10] a year to do all the lectures and then, you know, it’s, what, 18 days? Um, no. The good [00:48:15] that actually. Um. Yeah. Gin and Kirsch, they’re, uh, they’re quite humble guys, [00:48:20] right? They like, they they look like larger than life characters. They kind of are with, like, the hair and the facial hair, [00:48:25] but it’s all I think it’s all marketing like this, you know, the pointing at each other and the. But they’re, um. Yeah, [00:48:30] they’re really nice guys.

Payman Langroudi: Pleasant when you get to know them, because you imagine one thing and then you get [00:48:35] to know them. And it’s a totally different thing to what you imagined it would be.

Alex Hadley: Yeah, I’ve got a few. I’ve got a few friends like [00:48:40] that. I’ve got a couple of friends, um, a couple of friends who I’m still friends with from from university. And they, uh, [00:48:45] they, I remember them walking into the first lecture, uh, like, around. Well, first, [00:48:50] first lecture of the day around Christmas. And they were wearing matching Christmas pudding jumpers. [00:48:55] Right. And they were, they were half an hour late. So they walked all the way down to the front and sat at the front. [00:49:00] And I thought, I’m never going to be mates with these guys. These guys are ridiculous. I’m never [00:49:05] gonna be friends with them. Here we are like 12 years later and I’m really like nearly [00:49:10] best, you know, best mates with these guys. Yeah. Um, yeah. Really funny. So gin and Kirsch. Yeah. They, you [00:49:15] know, take, you know, your first glance, you think, oh, I’m not going to like these guys. And then they’re just really humble, [00:49:20] nice guys. Um, yeah. So, so they, um, I think they’re [00:49:25] like, they’re great kind of orchestrators, like, you know, conductors of the of the of the orchestra. [00:49:30] Um, and like, they, you know, they just bring loads of good guys in. [00:49:35]

Alex Hadley: Um, the other good thing about the Smile Academy was the [00:49:40] access for mentorship in practice. So if you can do all the stuff [00:49:45] that we were talking about before the communicating with patients, they’re talking to them about the best treatment options. [00:49:50] And then, you know, discussion of all the risks and benefits and pros, cons, time, cost [00:49:55] implications, whatever else. Um, then then, you know, there was an [00:50:00] availability to get mentorship in practice so I could start placing implants [00:50:05] on my own patients. And I can, I can imagine for for some people, that’s kind of tricky. If you if you [00:50:10] don’t have access to the patients, um, or the principal doesn’t trust you to be placing implants [00:50:15] on, on their patient, then then that that might be hard work. But actually it kind of all worked out really [00:50:20] well. You know, I get really good level of clinical freedom at all the practices I work in. Um, and, [00:50:25] you know, some Sermon and cash coming in to help with the surgery. It was really good. [00:50:30] And then I already, already kind of knew what I was doing with with restoring the model.

Payman Langroudi: You pay for the is [00:50:35] it did you say 18 days?

Alex Hadley: Yeah. So it’s I mean it’s about it’s about ten grand plus VAT [00:50:40] ten. And then you pay.

Payman Langroudi: For the mentorship on top.

Alex Hadley: You pay for the mentorship on top. But they’re fairly reasonable. [00:50:45] It’s like £300 an hour, something like that. But you’re charging the patient for so you know, not [00:50:50] not lots but I’m charging you know, charging the patient. Um.

Payman Langroudi: And so your first [00:50:55] few literally over the shoulder, you’ve got someone. Yeah.

Alex Hadley: Yeah, yeah. Placed like [00:51:00] five on the first day. They got so many. Yeah. Wow. Yeah. No it was good. Like, [00:51:05] it had, like a full surgical guide and all sorts. Oh I see. So it was like it was fully planned, you know vivo [00:51:10] Dental lab at the time. So, um. Yeah, you know, we. Yeah. [00:51:15]

Payman Langroudi: So immediately you’re almost confident. Almost. I [00:51:20] mean, that’s a big thing to say. Yeah.

Alex Hadley: I mean, yeah. Is that a thing? I don’t know whether it’s. Yeah. Is that [00:51:25] I think I’m. I think I’m where as, um, where as a student, I thought, [00:51:30] ah, um, the patient would be better seen by someone else. Now, I think [00:51:35] it could be a lot worse if they saw someone else. So I feel much, you know, I feel I feel very [00:51:40] confident that I’m trying to do the best thing for the patient. And so that’s the main [00:51:45] thing. Like, I’m not going to leave them, you know, stranded without an option or without a tooth [00:51:50] or you know, what, you know, with a complication that could be quite bad. With implants, the complications get [00:51:55] a bit messy. What was the.

Payman Langroudi: First complication you had?

Alex Hadley: Oh.

Payman Langroudi: Something [00:52:00] that surprised you?

Alex Hadley: Oh, I placed an implant. Then within two weeks, there’s kind of pus everywhere. [00:52:05] Had to take it out. I think it was just. I think it was high torque. It was quite high torque [00:52:10] and Solanki.

Payman Langroudi: The implant is a funny thing. Sometimes you do everything right, and yeah, it doesn’t [00:52:15] work.

Alex Hadley: No indication that the patient, you know, you know, relatively young guy like 30s, 40s. [00:52:20]

Payman Langroudi: Not smoker.

Alex Hadley: Not a smoker, medical history. You know, it’s like, you know, very. No, [00:52:25] no, nothing weird on the medical. Um, yeah. Surgery was [00:52:30] straightforward. Um. Didn’t do anything. Didn’t do anything. Didn’t do anything extra. What was the [00:52:35] first grafting? Gum grafting. What was the first.

Payman Langroudi: Complication that you learned something from? Because I guess that one was. [00:52:40]

Alex Hadley: The first complication ever.

Payman Langroudi: The first thing.

Alex Hadley: You learned.

Payman Langroudi: In a poignant. Yeah. In implants. [00:52:45] Learned a poignant lesson from.

Alex Hadley: Mhm. Well, that I mean [00:52:50] there are a few. Right. I can’t remember which one was the first failure but they, they fail. They fail [00:52:55] at say like, you know, 1% of the time they fail. So I’ve had a, you know, good few failures. [00:53:00] Um, I think you learned something different from each one. So I mean, that that one. Yeah. That case was, [00:53:05] you know. Oh, well, I knew it went in at pretty high torque. Um, so next time, [00:53:10] you know, don’t don’t put it in such high torque. You know, don’t push on the bone. Bone won’t necrose. [00:53:15] Um, yeah. Other other ones. Um, yeah. If the [00:53:20] bone is super hard, you know. Don’t use such an active implant. Um, you know, if you [00:53:25] get crestal bone loss around the implant, maybe place it a little bit deeper, or, you know, you can learn something else from from every [00:53:30] from every failure. There is, like, a reason, you know, why or [00:53:35] even every complication. And it’s like it’s an iterative process where you, you clearly [00:53:40] only really know what you’re doing when you’ve placed 500, 1000, you know, [00:53:45] that’s when you can kind of foresee what the problems might be before you place the implant. [00:53:50] Um, and kind of adjust your, your whole process in order [00:53:55] to favour success, whatever that success, whatever your, your definition of that success might be. [00:54:00] Um, whether that’s, you know, the aesthetic stuff or, you know, lower risk of complication [00:54:05] or, um. Yeah. Or or anything. Um, so [00:54:10] yeah, I think, I think it’s a, it’s a process and, and, and after that, talk to me in five years, [00:54:15] I’m sure I’m sure the complication rate will still be there’ll still be complications. There’ll always be complications, [00:54:20] but it’ll be.

Payman Langroudi: I’m interested in the early ones because they’re what puts people off going in. [00:54:25]

Alex Hadley: Yeah, but but like like you, you have to be honest with the patient. If you’re honest with the patient from [00:54:30] the get go, that this might not work. There might be problems with this. These are the potential [00:54:35] problems. Yeah. Um, then when you have a problem, it’s much easier to talk to them about the problems. [00:54:40] And if they if they do kick up a bit of a fuss, you know, you say, well, you know, I [00:54:45] was honest with you that this is a risk. Um, yeah. You [00:54:50] can do everything you can to try and avoid those, those those risks. You know, you’ve got guided surgery [00:54:55] or having a mentor or, you know, just different, different techniques. [00:55:00] Um, but but, you know, you can’t you can’t get rid of the risk of complications. [00:55:05] So you have to be you have to be confident that you can deal with the communication about the [00:55:10] the complication. You know what what happened? Why did it happen? Perhaps. [00:55:15] Um, sometimes I’ve, I’ve spoken to some dentists who’d rather say, oh, you know, I just [00:55:20] didn’t kind of didn’t didn’t work out. Um, and I try and try and, uh, like, [00:55:25] skirt over the issue, whereas I sometimes I feel, I feel like the patient kind [00:55:30] of knowing that if you, if you, if you do plan to replace the implant, like why it’s probably [00:55:35] still got a good chance of success. That’s quite handy. Yeah. So you know, oh, well, in this case, [00:55:40] this happened. You know, it failed. But, you know, I think I think I [00:55:45] know why it might have been a problem. Um, in future, I might think they might do things a little bit differently. [00:55:50]

Payman Langroudi: You know, some, some, some young dentists are paralysed by the fear of things [00:55:55] going wrong. Yeah. And constantly thinking about that.

Alex Hadley: I was I was talking to [00:56:00] a guy. Yeah. Uh, at, um, like, [00:56:05] at the weekend at Martin and Nick’s FP1 course. There’s a max. Max dude [00:56:10] from from Brisbane. And he said he’s, um, he’s so he’s, [00:56:15] he’s insured ensured to place implants but not restore them because GMC registered, not GDC [00:56:20] registered. Um, so obviously like placing the implants fine. Not doesn’t count as dentistry. [00:56:25] But he said he gets more more like more kicks [00:56:30] or like more stress. You know, the adrenaline from placing an upper central implant [00:56:35] versus doing these big cancer resections like, you know, cutting brain. He [00:56:40] reckons he’s 100,000 times more likely to get sued for the upper central implant [00:56:45] than the brain surgery, where, you know, they’ve consented the patient. You might [00:56:50] not be able to see or taste or, you know, hear or, you know. Yeah, [00:56:55] yeah. How interesting. Yeah. Really interesting.

Payman Langroudi: Because it doesn’t paralyse you somehow.

Alex Hadley: Um, [00:57:00] well, I mean, we like I all you all you can do is provide [00:57:05] the patient with it. Yeah. I mean, all you can do is provide the patient with the options, discuss which one you think is [00:57:10] the best option and why. Um, and kind of guide them. And [00:57:15] yeah, if something goes wrong, I mean it. Something, something. Something goes wrong. [00:57:20] It’s it’s both. It’s both a learning point and, [00:57:25] you know, a problem to solve. But you had a problem to solve before. Sometimes you place an implant. [00:57:30] Implant fails. What’s the what’s the real downside risk? Well, they’re only in the same position [00:57:35] that they were before. Yeah. Um, okay. Admittedly, sometimes it could be it could be a trickier problem to fix, [00:57:40] but but, um, no. Overall, I think, um, no, I’m not I’m not paralysed [00:57:45] by it. I, I think I think just speaking to people [00:57:50] frankly about what’s happened is sufficient. And you have insurance. [00:57:55] It’s not like, you know, everyone’s going to get a letter.

Payman Langroudi: It doesn’t. We can all sort of talk [00:58:00] about it and logically sort of say it. Yeah. But some people, their demeanour is to [00:58:05] be paralysed by that fear and some people their demeanour isn’t.

Alex Hadley: I think we can hit the, um, the [00:58:10] personality trait. Yeah, exactly. Again, my super low in neuroticism. Yeah. Yeah. Lots [00:58:15] of people like to say, oh, I don’t care what other people think. Yeah. I actually don’t [00:58:20] really don’t really care what they think. Yeah. What they think. Um, you know, it’s just it’s just [00:58:25] like a rational, problem solving mentality. It’s like, if this, then this, if that.

Payman Langroudi: Then what’s [00:58:30] the what’s the most complicated implant case you’ve done? I mean, how how far have you complicated. Do you graft. Do you sinus [00:58:35] lift.

Alex Hadley: Do you do some stuff that I know? Uh, well I know [00:58:40] Paul. If he’s listening, it doesn’t. He’s not big on immediate loading or bone grafting or any of [00:58:45] that stuff. Like he likes just using, like, host bone and whatever. But I think increasingly immediate [00:58:50] loading full arches is becoming the norm. Um, so what. [00:58:55]

Payman Langroudi: Do they call for?

Alex Hadley: Yeah. So I’ve got I’ve got a few of those lined up. I’ve [00:59:00] not done much immediate loading yet. Um, like in the grand scheme of things [00:59:05] I have, I have done. Well, I guess I have done quite a bit of immediate loading, but not, um, I it’s all relative, [00:59:10] right? Compared to Martin and Nick, I’ve done nothing. Yeah. Um, compared to your average dentist placing, [00:59:15] you know, 12 implants a year? I’ve done loads. Um. But. Yeah. Immediate [00:59:20] loading. Full arches is really tricky. Um, but, [00:59:25] yeah, I mean, I mean, what? I was trying to work this out yesterday. I’m probably including, [00:59:30] like, travel and food. I’m probably 100 grand in courses, so [00:59:35] I, you know, you just need to speak to people who who have already experienced [00:59:40] all these. But there are two different ways to learn, right? There are two different ways to learn either. Um, find [00:59:45] out from your own failures or find out what to do from other people’s failures. [00:59:50] Yeah. It’s quite. It’s nice to find them out from someone else. Of course. Really [00:59:55] handy to avoid the failures in the first place or avoid avoid the complications. Um, so [01:00:00] yeah, I mean, Martin and Nick, also, guys that I met from bath.

Payman Langroudi: Um, Martin [01:00:05] and Nick, ten Dental. Yeah. Yeah.

Alex Hadley: Good. Great. Great, [01:00:10] guys. Yeah. And then, um. Yeah. Met Paulo Carvalho last last week [01:00:15] at their course, and, uh. And he’s speaking at Bard. So, um, [01:00:20] I hope he’s speaking on the. I hope he’s speaking on the Friday because Martin tasked me with [01:00:25] looking after him on Friday night. So let’s hope he’s not like a Saturday morning lecture. Oh, no. See [01:00:30] if we can break the Portuguese man. Yeah. Um, but. No. But but so? [01:00:35] So, yeah. You know, um, you just got to have have, you know, guys who’ve done it before, [01:00:40] who’ve had these problems before. Yeah. And if you can’t fix it or if the patient doesn’t want you [01:00:45] to fix it because they’ve lost faith in you, which fortunately hasn’t happened yet, you. It’s [01:00:50] nice to have guys like them who are super knowledgeable and, like, really generous [01:00:55] with their knowledge, um, to help you fix the problem or to fix the problem for you.

Payman Langroudi: Well, [01:01:00] in that vein, in the vein of learning from each other’s mistakes. Yeah. We come to the darker [01:01:05] part of the pod. What comes to mind [01:01:10] when I say clinical errors? What clinical errors have you made that other people can learn from?

Alex Hadley: It’s [01:01:15] all it’s all communication based. I [01:01:20] treated a patient in PhD, um, trying to do some heroic [01:01:25] dentistry on, you know, a couple of lateral incisors that were root treated. They [01:01:30] were also bridge abutments for a four unit bridge. 2 to 2. Yeah. And so I spoke [01:01:35] to my, my, you know, PhD trainer, and he was like, yeah, yeah, yeah, we’ll we’ll do it. We’ll root treat that abutment [01:01:40] and then you’ll replace the bridge. And I wouldn’t even do that now. Mhm. Um but he thought [01:01:45] oh it’d be good. You know it’s good practice for you patients you know being treated on the NHS. We’re trying to do them [01:01:50] a favour but I don’t think I hadn’t, I hadn’t communicated all [01:01:55] the risks properly. When I went to take the temporary bridge off.

Payman Langroudi: Um, half [01:02:00] the tooth fell off.

Alex Hadley: Yeah. Obviously, obviously the obviously the prep kind of dechlorinated in the temp [01:02:05] and there’s a click, you know. But the click was the the luxe attempt fracturing, not the tooth fracturing [01:02:10] which was already fractured. You know, it was kind of mobile when she came back. Um, and so [01:02:15] she her opinion was that I had broken the tooth. And so, you know [01:02:20] what I mean? What did we do? I think now now, what I would do is like [01:02:25] everything possible to not leave that lady without teeth. Uh, but at the time, [01:02:30] got my trainer in. He was a bit, you know, bit old school, like, very, very good [01:02:35] dentist, but a bit old school. He was like, right, we need to take an impression. You need a denture. This denture [01:02:40] time, it’s denture time. Right. So we’ll get quick turnaround on a denture. You have a couple of days. You know. [01:02:45] We’ll get it sorted over the weekend. Coming on Monday we’ll give you a denture. So like 3 or 4 days turnaround. [01:02:50] How old was she? Uh, she was like in her 60s, but obviously devastated. She lost her front [01:02:55] teeth. Yeah. Um, what would I do in hindsight? Well, first of all, wouldn’t have been planning that, um, [01:03:00] just en route, treated abutments, you know, probably probably wouldn’t have bothered now.

Alex Hadley: It would be an [01:03:05] implant case. Right now it would be an implant case before I touched it, um, would have [01:03:10] a CT and have spoken to her about the best option. And then if if she [01:03:15] chose the, you know, the alternative option, which is not the implants and [01:03:20] something went wrong, I’d be you know, I’d be saying, well, I told you about this. We discussed it at length. [01:03:25] You got a letter? Yeah. You remember the letter that you read? And so. Yeah. Like that’s the. Yeah. So so yeah, [01:03:30] that that, that that’s probably the worst one. That was um, I think she decided after a, after a couple of years. [01:03:35] So it’s still, you know, it was probably only a couple of years ago, uh, we got a letter, like [01:03:40] a solicitor’s letter. She obviously, you know, had a denture, wanted [01:03:45] implants, wanted them for free. Still felt, you know, um, still felt [01:03:50] that she’d been kind of affronted or, um, so that it kind [01:03:55] of it went nowhere. Like the note. The note. Our notes were perfect, right? It was like, you know, this this is what happened. [01:04:00] And then it was corroborated by my PhD trainer. And he was, you know, his [01:04:05] vicarious liability. You know, we both spoke to DS, uh, at the time [01:04:10] and then, you know, later, and we were trying to do her a favour and it was, [01:04:15] you know, you know, the intention was, was known.

Alex Hadley: And so it didn’t go anywhere. But [01:04:20] it took ages for, um, the indemnity organisations to take that off, [01:04:25] you know, to like, you know, clear your record. Yeah, yeah, yeah. It took years, like [01:04:30] three years or something. Um, yeah. Now I’m with TDs. I [01:04:35] can’t speak highly of them. More highly of them, to be honest. Like you had to call them. Uh, [01:04:40] yeah, I yeah, a couple of times. Um, interestingly, never like [01:04:45] the there’s never the high risk stuff. There’s always like, fillings or something. Yeah. You know, a patient, you know, [01:04:50] patient turns up saying, oh, you know, you drill too much of my teeth and it’s sensitive. It’s like, well, no, [01:04:55] I’ve got a photo. Yeah. You know, just where they get a bit. Yeah, they just get they sometimes get [01:05:00] a bit funny, which comes down to communication. Yeah, it’s always like it’s always treatment [01:05:05] that I’ve kind of, I think because I see the case and I think, look, I can, I can sort you, I can help you out. Now, [01:05:10] you know this. Um, actually, one of one of these. Yeah. Was not, um, wasn’t even a sensitive [01:05:15] tooth.

Alex Hadley: A patient came in with, like, a little, you know, chipped, uh, like, [01:05:20] incisal edge on a central and had clearly been repaired with composite before. And I said, well, you know, [01:05:25] I probably don’t even need to use local. I can, you know, get this off for you and, uh, and put, [01:05:30] put a new composite on and it’s the bread and butter. I do, you know, thousands a year. So [01:05:35] you know why? You know what would what would be the problem? Um, but it’s like the treating the patient without [01:05:40] having built the rapport, you know, rushing to get to the treatment, because I think that it’s [01:05:45] more effective for them. Yeah. What’s the best option for them for fix the tooth now. But actually [01:05:50] that, that, that, that can put you in a tricky situation where, you [01:05:55] know, maybe it would have been better to find out why this patient is [01:06:00] so worried about me removing the old composite. You know, what’s this? You know. Do they have some? Almost [01:06:05] like, psychological profiling? Yeah. Um. And now working in the Botox practice, you [01:06:10] know, face mad, um, that there’s, you know, the the patients [01:06:15] are great. The patients really want aesthetic treatment, but there they are. [01:06:20] Yeah, they are very discerning. Yeah. So tell us.

Payman Langroudi: About that practice. Face met.

Alex Hadley: Uh, [01:06:25] face met. Uh, Billericay. Yeah. Um, yeah. The the, [01:06:30] uh, principle is not dentist. She’s a medical nurse with 20 plus [01:06:35] years in facial aesthetics. Super interesting. She’s really cool. Yeah. [01:06:40] Um, incredible businesswoman, Monica Barranger. Uh, her son’s a dentist. [01:06:45] Works in the practice. Um, there’s another dentist and myself. There’s an [01:06:50] operating theatre downstairs, and, uh, they have plastic surgeons [01:06:55] on rotation. Station is plastic surgeons take referrals from Monica for, you know, off [01:07:00] her list for blepharoplasty or liposuction or whatever. Um, [01:07:05] and then there’s a foot and ankle surgery list, bunions, that kind [01:07:10] of stuff. Like there’s almost like an NHS list there as well. Um, yeah. [01:07:15] Very cool. Cool. Cool practice. Uh, really nice setup.

Payman Langroudi: Does it look nice as well?

Alex Hadley: Yeah. [01:07:20] Everything’s white. I kind of feel like it’s almost like this. Payman. Um, it’s [01:07:25] like. I feel like, um. I feel, you know, uh, in Bruce Almighty, like, uh, Morgan [01:07:30] Freeman is, like, in heaven, right? He’s like in heaven. Everything’s white. That’s kind of how I feel in face med. It’s, [01:07:35] uh. Yeah, very clean, very, very clinical. Um, but, yeah.

Payman Langroudi: The patients. [01:07:40] Are you doing similar work or more complex work there?

Alex Hadley: Similar work? Yeah. So general dentistry [01:07:45] and general dentistry. Implants and smile makeovers. Yeah, yeah, yeah.

Payman Langroudi: Let’s talk about [01:07:50] smile makeovers. So you worked with ash for a while?

Alex Hadley: Yeah, for short for [01:07:55] a short while. Yeah.

Payman Langroudi: And you did the course?

Alex Hadley: Obviously. Yes. Yeah.

Payman Langroudi: And you do a lot of small makeovers. Porcelain [01:08:00] smile.

Alex Hadley: Makeovers? Yeah. Do a good mix. Mostly. Mostly ceramic. Yeah.

Payman Langroudi: And I [01:08:05] noticed quite a lot of composites as well.

Alex Hadley: Yeah. Well, I mean, the, um. Yeah, you can’t [01:08:10] you can’t discount composites as a as a material, but it’s definitely an inferior material. [01:08:15] Right. It doesn’t it doesn’t last as long, of course, you know, chipping, staining whatever else. [01:08:20] Um, but yeah, lots of patients want it. And, you know, they don’t want prep prep [01:08:25] teeth. Um, sometimes I do. I’ve done some, uh, indirect, [01:08:30] uh, kind of ceramic composite hybrids as well. So I’ve done some of that prep [01:08:35] and no prep. Probably a mistake. No. They’re okay. I’ve not had problems with them. I’ve not had problems [01:08:40] with them. Yeah. No. Hard to get that right. Yeah. They are tricky. As long as you’ve got the right tooth shape. You need [01:08:45] a good tech. You need a good tech. Right? Yeah. Um, and also the good techs, they tend their tendency is to make [01:08:50] them too thin. Mhm. Because they want like, you know, they almost want to show off like ideal. [01:08:55] Yeah. So they kind of make this the indirect, um, kind of composites, the milled composites [01:09:00] a bit too thin, especially the hand finishing them from half a mil thick to, [01:09:05] you know, when you say too.

Payman Langroudi: Thin, what is it, the.

Alex Hadley: Risk of fracture. Oh, it’s a risk of fracture. [01:09:10] Yeah. Yeah, yeah.

Payman Langroudi: Had issues with that from physical?

Alex Hadley: Yeah. It’s just mechanical. Yeah. But I mean, at least [01:09:15] they don’t stain up. They look nice at, you know, three years, they still look good. Like [01:09:20] composite bonding. You know, patients, if patients don’t look after them, even if [01:09:25] they do look after them maybe kind of five years, they start to kind of stain up [01:09:30] and then got them off and. Yeah, we.

Payman Langroudi: Teach on on. We teach [01:09:35] to bleach them.

Alex Hadley: Oh yeah. Yeah, yeah I get them to that and sensitive toothpastes because [01:09:40] they’re less abrasive. Yeah.

Payman Langroudi: Um, we’ve done the bleach, the composites one one [01:09:45] day a month. Okay.

Alex Hadley: Yeah.

Payman Langroudi: To prevent from.

Alex Hadley: Stain. Yeah. I met Depeche at Bard as well. That’s [01:09:50] right. Yeah, yeah yeah.

[TRANSITION]: Yeah.

Alex Hadley: Yeah. No. Yeah. In fact he, he, he did a, he did a talk [01:09:55] with the, the, the amazing photo of the fractured tooth with one of his [01:10:00] engineers with the four layers. That’s just. Yeah. Crazy. I’m not I’m not big on kind of layering [01:10:05] composites. I don’t you know, I’m not a single shade. Yeah. Like mono shade builder. I think Patience [01:10:10] in Essex wants straight white teeth. They want primary anatomy. Yeah. You know, as as.

Payman Langroudi: Primary anatomy is [01:10:15] the key. Yeah. People who try and get on to secondary and tertiary without [01:10:20] doing primary properly. Yeah, there’s lots of that going on.

Alex Hadley: It looks a bit silly.

Payman Langroudi: It’s silly, [01:10:25] it’s silly. If you could just do primary, you’ll make most patients happy. Yeah. And many [01:10:30] people can’t just do primary, you know. Can’t do it. Well, yeah.

Alex Hadley: Um, I think [01:10:35] you have to have a bit of an eye for it. It’s handy. Composite works handy for the implant stuff because [01:10:40] of the temporary PMMa temps. Yeah, if you’ve got a patient in temps. Yeah. Yeah, it’s kind of [01:10:45] handy because you can. Yeah. I mean, you can add composite and change like the contour, the restoration [01:10:50] and move, the gingival zenith and all this stuff. Um, yeah. Yeah. [01:10:55] So sometimes I get a try in restoration back and it’s, [01:11:00] it’s easier for me to prep the tooth that let’s say it’s like a, a cantilever bridge [01:11:05] central on, like a single central implant. Right. And it’s, and it’s a little bit rotated I can just prep it back, [01:11:10] you know, change the shape of it and then scan it Intraorally [01:11:15] send that to the tech or take a little putty of it, and then he can copy that. Exactly. Take a full face photo. You can [01:11:20] move the midline. Um, and like, you know, it’s it’s a one step finish. Yeah. [01:11:25] Whereas if I just take a photo and send it to him, it’ll come back. It’ll still be wrong. [01:11:30] It’s obviously still going to be wrong. Um, yeah. Having a technician who’s good, who you can [01:11:35] work with that closely is really, really handy.

Payman Langroudi: Really important. Yeah. You know, I think [01:11:40] people underestimate how much they can learn from their technicians as well.

Alex Hadley: Yeah, I mean, I took it I [01:11:45] forced him to come with me to Martin and Nick’s next course last week. Yeah yeah yeah yeah.

Payman Langroudi: I learned loads [01:11:50] from one of my technicians. The guy was just brilliant. Yeah. And I learned loads and loads and loads [01:11:55] from him. Um, I think people underestimate how much they can learn from sales reps. Yeah. The constantly [01:12:00] sales reps being stopped from seeing the dentist. The sales reps got this like loads and [01:12:05] loads of knowledge from the market. Yeah. Yeah. Um, that the receptionist [01:12:10] would do well to encourage sales reps. Yeah. I mean, I’m not I’m not even talking from [01:12:15] the selling anything to the to the dentist. I’m talking about that sales rep has talked to a [01:12:20] thousand dentists. Yeah. Yeah.

Alex Hadley: And and dentists know they’re being sold to.

Payman Langroudi: No, [01:12:25] no, but this has spoken to a thousand dentists, right? Yeah. So understands what lots of people [01:12:30] are saying. Yeah, yeah. About any aspect of, of the, of [01:12:35] course, the aspect that that sales rep is selling. Let’s say he’s a scanner seller. Yeah. He’s [01:12:40] talked to a thousand dentists about scanners. Yeah. The questions that different people are asking, what they want [01:12:45] and all that.

Alex Hadley: And you can modify the product.

Payman Langroudi: But also those thousand dentists have told him things like, I can’t find [01:12:50] a nurse, or I found a place to find a nurse or, you know, in the chit chat, you [01:12:55] know, it’s important. It’s important. I want to move on [01:13:00] to the future. Yeah. Because, you know, you’ve got a lot of potential. [01:13:05] Um, I said, I started off by saying I started enlightened. Same age as you are now. [01:13:10] Yeah. Are you the type to start a practice? [01:13:15] Are you the type to teach?

Alex Hadley: I think I think the the practice is [01:13:20] the logical next step. I think it I think it is. Um, do [01:13:25] you think it’s.

Payman Langroudi: Something you do alone or in partnership or.

Alex Hadley: Um, I think I do it alone. Having [01:13:30] looked at the personality test that, you know, we were discussing earlier, I think I would [01:13:35] need to hire for my, my deficiencies. So I think, you know, my organisational [01:13:40] skills are pretty poor. I’m quite big picture thinker. Um, so. Yeah. Have [01:13:45] it. You know, I need someone detail oriented to to sort that out. I think practice is is [01:13:50] going to happen.

Payman Langroudi: Um, I wouldn’t discount a partnership if you’re that person. Yeah, [01:13:55] because it’s good to have a partner who’s obsessed by systems. Okay. [01:14:00] Yeah. Because if you’re not. Yeah, yeah, yeah. Um, you can say I’ll hire someone in for that [01:14:05] job. Yeah, yeah. But then let’s let’s say you’re not good just for the sake of the argument. Say you’re not good with accounts. [01:14:10] Yeah, yeah. If you don’t understand a spreadsheet and you know, the way [01:14:15] the profit and loss and all that, you can hire someone in for that. Yeah, yeah, but [01:14:20] a.

Alex Hadley: Partner is going to have like a vested interest in it. Yeah.

Payman Langroudi: No partner. Yeah. Is is [01:14:25] what you want in that situation. Yeah. You want someone to really understand and not, [01:14:30] by the way, steal from you. Yeah. You know there’s so many. What are you going to do. Hand your, your bank [01:14:35] card over to someone you don’t know at all. You know, I’m not saying it’s the wrong. Yeah, yeah. There [01:14:40] are people who who don’t want partners. Yeah, and they shouldn’t have partners because they’ve [01:14:45] got very strong ideas and they don’t they don’t want to sell an idea to anyone. [01:14:50] Mhm. Um, but I’m saying don’t discount it anyway. Yeah.

Alex Hadley: Yeah. [01:14:55] So. Yeah. Yeah. Noted. Yeah. Thanks. Thanks.

Payman Langroudi: Well, how far are you? Are you. Are you [01:15:00] literally looking or.

Alex Hadley: I’ve been looking for. Oh I’ve been looking for a while. There is like [01:15:05] a. Yeah there is. Yeah. I’ve got something cooking but. Oh, really? Sure. Yeah. It’s not nothing set [01:15:10] in stone, as you all know. So. Yeah.

Payman Langroudi: Can you tell us anything? Squat or. Existing. [01:15:15]

Alex Hadley: Existing. Existing. Practice? Yeah. Room. Room for lots [01:15:20] of extra surgeries.

Payman Langroudi: It’s a good idea. Good idea to do that. Right.

Alex Hadley: Good car parking. [01:15:25]

Payman Langroudi: Good car parking.

Alex Hadley: So it’s like, you know, there are fundamentals that are good. Um, [01:15:30] no, I have tried I’ve tried to buy a couple before. I’ve put put a couple of offers in, but nothing’s worked out. [01:15:35] Um, and then one.

Payman Langroudi: Thing you should bear in mind is that the Dentist [01:15:40] nurse relationship, which I’m sure you’re great with all your nurses is different. [01:15:45] Yeah. When you’re the owner, is it? Yeah.

Alex Hadley: Very, very different. It can be quite jovial. [01:15:50] Yeah. I’ll turn up as the associate and, like, make jokes.

Payman Langroudi: Brilliant associate. It was a brilliant [01:15:55] associate, man. And me and the nurse were, like, in a team together. And our room was very proud [01:16:00] of what we did. I would always represent the practice myself. Try really hard to explain what the [01:16:05] practice is doing and all that. Yeah, yeah, yeah. As an owner. So stuff comes up that just. It’s [01:16:10] just unpleasant, man. Yeah. Unpleasant stuff comes up. Um, yeah. As an associate, it’s very [01:16:15] rare that unpleasantness happens to you.

Alex Hadley: Leave that at the door. Yeah, yeah, yeah. I mean, that [01:16:20] is. I’m in the fortunate position. I think it’s probably one of the reasons why I could progress clinically so quickly is I [01:16:25] have nothing else to worry about. Right. I don’t have to worry about making payroll or whatever [01:16:30] else. I can just concentrate. Just know kids. Yeah. Um, mortgage? [01:16:35] No kids, no mortgage? No. Like, I’m a I’m a I’m a free man. Oh, lovely. [01:16:40] Um, yeah. So. So, yeah, I’ve almost. I could effectively have almost no [01:16:45] overheads. Um.

Payman Langroudi: It’s interesting. You should. We should have a conversation about what you should do in [01:16:50] this moment. Yeah. Um, but what about teaching?

Alex Hadley: Yeah. Would like [01:16:55] to would like to teach a prep course or, you know, small makeover course from [01:17:00] patient journey through to, you know, planning and execution of [01:17:05] small makeovers with, you know, bonding porcelain veneers. Um, and then I think [01:17:10] the I think the plan is when, let’s say when in five years [01:17:15] when I’m, you know, as, as, as good at some of these other guys doing FP1 full arches [01:17:20] and, and soft tissue grafting then. Yeah, I think an implant course would be good as well. Um [01:17:25] but I think I need to, I need to get through to that thousand implant mark.

Payman Langroudi: So you reckon [01:17:30] in the porcelain area you’re further ahead than you are in the implant area? As [01:17:35] in, you feel confident that you can teach the porcelain. Yeah.

Alex Hadley: Yeah, yeah. So I’ve done. Yeah, I’ve. [01:17:40] I was trying to work out how many smile makeovers I’ve done on like, through in, like, composite or [01:17:45] ceramic and it’s got to be, it’s something like, you know, from 4 [01:17:50] to 20 5 or 4 to let’s say 28 units. I don’t think I’ve ever done a 28 unit, but let’s [01:17:55] say 4 to 24 units. I’ve probably done over 500 cases, like probably [01:18:00] nearing a thousand, you know, mini smile makeovers with composite veneers or [01:18:05] porcelain veneers or bigger, bigger cases.

Payman Langroudi: I mean, no wonder Will buys you whatever you want. [01:18:10] Yeah, you’re you’re a profitable associate, right? Yeah. If [01:18:15] that’s the case.

Alex Hadley: He I guess he knows that he does know that he’s a good he’s a good [01:18:20] principal as well. He is good.

Payman Langroudi: So what are we talking this courses on the horizon [01:18:25] like. Yeah.

Alex Hadley: So I’m planning of course. Yeah. We’re planning the course. We. Yeah I say [01:18:30] planning. We’re in the very early stages of planning a course. Um, yeah. Everything from kind [01:18:35] of photography, communication, presenting cases to patients or presenting a treatment [01:18:40] plan, and then the the steps involved in, you know, prep [01:18:45] review fit and then a final review and and [01:18:50] like everything everything that we’ve learned in that.

Payman Langroudi: So so give me a little hint [01:18:55] on is there something you do differently to, I don’t know, Gallup grill [01:19:00] technique because I spoke to Sam Jethwa.

Alex Hadley: No.

Payman Langroudi: So he does. He [01:19:05] does. He does it differently. Yeah.

Alex Hadley: Interesting. So, um, no. So Gallup grills apt [01:19:10] technique. Right. Which is, um, is effectively what ash is teaching. Um, yeah, [01:19:15] I think no, I think that is, that is like a standard veneer preparation [01:19:20] technique. Now that’s like that is how so minimal. So then the value add.

Payman Langroudi: The value [01:19:25] add you’re saying the value.

Alex Hadley: The value add is is is all in communication. [01:19:30] And the patient journey from start to finish. And then.

Payman Langroudi: And bits and pieces. Right. [01:19:35]

Alex Hadley: Bits and pieces. There are some crucial bits and pieces. Don’t hit me.

Payman Langroudi: With one of those.

Alex Hadley: Oh, use the right [01:19:40] burr. Use a sharp burr, you know. Use this burr. Burr. Use this new burr. Yeah, [01:19:45] use this burr. This is the one that you need to use. Yeah. You know, um, yeah, [01:19:50] I think I think, um. Yeah. Fractures in temporaries. You know what? What, like troubleshooting [01:19:55] things like that?

Payman Langroudi: Because when I used to do veneers, uh, porcelain veneers when I was a [01:20:00] dentist. Yeah. And one thing that used to just pain me used to hurt me. I didn’t, [01:20:05] you know, the the tension between when the, when the stats came out on the bond [01:20:10] strength to enamel compared to the bond strength to dentine. Right. Yeah. The tension between [01:20:15] trying to stay in enamel. Yeah. And yet. And then.

Alex Hadley: Prepping heavily enough, prepping.

Payman Langroudi: Heavily enough [01:20:20] that the technician can see the line. And also sometimes the the more you prep [01:20:25] the better the look of the. Because because you know, you don’t want the veneer to be bulky.

Alex Hadley: You’re [01:20:30] not wrong.

[TRANSITION]: Yeah.

Alex Hadley: So, yeah, I mean, you have to. Yeah. Which is I guess.

Payman Langroudi: It is the Gallup grill technique that sort of. That’s the whole point [01:20:35] of the Gallup.

Alex Hadley: Get your get your wax up. Right. And then it’s fine. Yeah. Then you can then you know that you know that you [01:20:40] have a happy patient. And, um, I mean, even now with. So I’m [01:20:45] even learning stuff from, uh, say, Martin’s course where the, [01:20:50] uh, implant treatment planning could be effective for demonstrating [01:20:55] smile makeover outcomes for patients, where you’re doing where they’re not [01:21:00] additive, where you’re subtracting, you know, where you’re making teeth smaller, something that we can’t try in the mouth. [01:21:05] So, um, yeah, I mean, yeah, the key is the key is to have the [01:21:10] wax up as close as possible to the finals. Yeah. So you have as little alteration [01:21:15] as. But I mean, we’ve all been there, right? If you if you were doing veneers, you know, you’ve had a patient in the chair, you know, [01:21:20] 18 hours messing around with temporaries. You know, patient’s not happy a [01:21:25] little bit dysmorphic, you know that what they’re what they’re thinking is [01:21:30] what? You know what they think. All these. All these beautiful, enlightened marketing photos. [01:21:35] Smiles look like, you know, that’s what they want. They think they’re going to get there by changing their teeth. And, [01:21:40] you know, it’s often like a, you know, a broader, um, [01:21:45] you know, a broader problem.

Payman Langroudi: If you’ve done that many small makeovers, you must have come [01:21:50] across that that nightmare situation where after fit [01:21:55] patients, family member says, don’t like them and the patient comes back and says, I don’t like [01:22:00] them anymore. Yeah. Whatever they said about temporary.

Alex Hadley: Yeah, yeah, yeah. Because [01:22:05] patients are patients are of course. Yeah. Of course it’s happened.

Payman Langroudi: The um how have you handled that.

Alex Hadley: Well [01:22:10] that’s difficult. Have you ever had.

Payman Langroudi: To re prep like. Because once once the patient once let’s [01:22:15] say you do the temporary the patient says I love that. Yeah. You put you fix them permanently. [01:22:20] Patient says I don’t love that. Yeah. Yeah. Now you’re in such a terrible situation because if you’re [01:22:25] prep and that’s going to cost you time and money and effort and.

Alex Hadley: Yeah, I don’t I don’t actually think they’re going to.

Payman Langroudi: Be [01:22:30] successful the second time because yeah that patient something up. Right.

Alex Hadley: Well ash [01:22:35] would keep ash would keep going until the patient’s happy I know.

Payman Langroudi: But what you know, the patient was happy [01:22:40] at the temporary phase. Yeah, yeah, yeah. So that’s a bit weird. Yeah.

Alex Hadley: Or there or they, they decided a shade and [01:22:45] they weren’t happy with the shade after a while. And then you, you know, charge them a lab fee or something to replace it. You tend [01:22:50] to.

Payman Langroudi: Push patients into whiter than they think or into darker than they think.

Alex Hadley: Uh, [01:22:55] my I’m tending to. Well, so we’re in Essex, right? This [01:23:00] is, you know, patients want straight white teeth. If they get if they get super tanned, I [01:23:05] think Bl2 can look really silly. You know, sometimes it can look really silly. So [01:23:10] I try and I try and show them. They’ll often just choose the lightest shade tab you show them. [01:23:15] So I try and talk to them. Yeah, I try and talk them down from bleach three, [01:23:20] down from bleach three. And my technician can we can decide on a bleach three and he can stain them up and [01:23:25] like knock them back. So we. Yeah we can sometimes we can sometimes get between shades [01:23:30] but yeah increasingly. And do you ever.

Payman Langroudi: Use different shades cements to.

Alex Hadley: Yeah. [01:23:35] Yeah yeah I mean I’m a bit I’m more of a fan of uh, using the lighter [01:23:40] cements on the basis that if there if there is a marginal gap, it’s [01:23:45] easier to hide with a light coloured cement. So if there’s any kind of if there’s any kind of marginal gap [01:23:50] then it’s, it’s more easily hidden because if the, if the, even if the stump shade is quite, [01:23:55] quite light, um, if you’re using it a clear cement or, you know, translucent [01:24:00] cement, it might especially if we’re using bleach three, you know, veneers. Um, [01:24:05] then yeah, it’s a bit of a. Yeah. Using this like neutral cement. It’s [01:24:10] it’s not I don’t find it as useful as some of the other guys to kind of [01:24:15] alter. It alters the shade so, so minimally that I don’t, I don’t find, I [01:24:20] don’t find it that helpful. Um, the also your layer of cement is so thin [01:24:25] that it doesn’t really doesn’t really matter. Um, but you know. [01:24:30]

Payman Langroudi: You can use more opaque cements as well.

Alex Hadley: Yeah. I mean, yeah you can. Yeah. So I mean that’s probably [01:24:35] more, that’s probably more, more important. Like whether you’re going to use an opaque cement or whatever. I think the thickness [01:24:40] of the material is probably like the main, the main thing. Yeah. If you got a tooth that’s really dark, [01:24:45] don’t bother using an opaque cement. Just, you know, you have to prep it a bit more.

Payman Langroudi: What are you charge [01:24:50] a unit. Does it depend?

Alex Hadley: It’s quite reasonable, actually. Um, yeah. Eight, £900 a unit. [01:24:55]

Payman Langroudi: And typically do eight or.

Alex Hadley: More in. Well, it depends. [01:25:00] I mean, I do whatever’s whatever the, whatever the clinical indication [01:25:05] is. Yeah. But I don’t, I don’t like, I don’t, I don’t like doing six. Yeah. So I mean that’s [01:25:10] quite common. Not not enjoying doing six. Um, so.

Payman Langroudi: You’re bleaching for the canine and then. [01:25:15]

Alex Hadley: Um, yeah. Although although, like the patient said, canines bleach terribly. Right. We know that, [01:25:20] um, just loads of dentine. Um, yeah. Usually like upper and lower tooth whitening [01:25:25] for doing a small case, like a four unit case. And then make sure that make [01:25:30] sure that we’re, we’re happy with the shade. I mean, you can get away with slightly lighter for like front, front for [01:25:35] teeth, but, um, yeah, I mean otherwise for 810. Um, [01:25:40] not huge on doing veneers on sixes, but you know, maybe like overlays [01:25:45] or whatever if, if.

Payman Langroudi: Lower veneers as well.

Alex Hadley: Yeah. Yeah. Sometimes. Yeah. So I mean I’ve [01:25:50] yeah. Got some, some cool cases where I’ve done um like mixed cases where I’ve placed the implants [01:25:55] to replace, you know, primary teeth, C’s and E’s and [01:26:00] whatnot, and then, you know, have the patient at increased ovd prep, like, [01:26:05] uh, 4 to 4 on the upper 3 to 3 on the lower. Um, and then, [01:26:10] you know, weight things, dial in and then prep [01:26:15] the posteriors and restore, you know, uh, restore all of the anteriors first [01:26:20] and then prep the fives and sixes a bit later on. So yeah, that’s where [01:26:25] I have to use my brain. I really like those. That’s my favourite. That’s my favourite, my favourite type of case. You [01:26:30] know something where there’s a little bit of clinical problem solving. Um, and where.

Payman Langroudi: Cases [01:26:35] as well.

Alex Hadley: Yeah, yeah yeah, yeah. So yeah. So again like learned from [01:26:40] working with ash you know using composite ball or leaf gauge. Um measuring CJ to CJ [01:26:45] you know propping patients open. Not I mean he’s he’s not a big [01:26:50] fan of prepping everything all at once. I also don’t fancy prepping everything all at once. I don’t think it’s I don’t think [01:26:55] it’s necessary. Um, yeah. Yeah. So all sorts really. [01:27:00] And yeah, it’s interesting what patients will tolerate. Like they’re kind of changes that they’ll tolerate. Um. [01:27:05] Yeah.

Payman Langroudi: Really until one doesn’t. Right.

Alex Hadley: Yeah. Well that. Yeah. Well that’s. [01:27:10] Yeah, that’s the thing. Right. Yeah. Some, some patients when you do this kind of work, particularly at increased OCD, [01:27:15] my actually my least favourite thing for a technician to do is increase the [01:27:20] ovd on the finals. So you know, not so. We do our best to try and mimic [01:27:25] exactly what we want in the in the finals, in the temps. And I scan them and [01:27:30] I say copy that. And then they say, oh, I just, I just did a [01:27:35] little bit, just like I’ve just opened them up by, you know, one and a half mil. So on the cusp [01:27:40] of the canines or whatever or cusps of the, the premolars, you’re like, well, now I’m [01:27:45] going to have to I have to prep those. Yeah. You’ve made my life really difficult now because [01:27:50] especially if the patient’s like, um, kind of, uh, fixated [01:27:55] on their occlusion, you get these patients, these kind of bruxism that [01:28:00] are constantly mentally taxing. They’re. Yeah, they’re mentally fixated on their, like, on tapping their teeth and [01:28:05] just seeing like, where is it like what’s it what’s heavy? Where’s the heavy contact. There’s always [01:28:10] going to be like, uh, you can use t scan, you can get the models equilibrated. [01:28:15] You know, you can do you can do all sorts of things, try and fix this. But yeah, if they’re if they’re occluding [01:28:20] on a little bit of ceramic that they weren’t expecting to, but they liked the temporaries, they’ll be thinking, [01:28:25] what’s, you know, what’s wrong. And that’s like that, that that takes hours to train. You know, you.

Payman Langroudi: Could you can [01:28:30] have all sorts of articulators, T scans, whatever you like here. There’s no way of accounting for [01:28:35] the patient’s psychological state on that day. No. Yeah. On that day, he could be stressed [01:28:40] and his muscle tone could be different to what it is normally especially like.

Alex Hadley: And sometimes [01:28:45] TMD exacerbated by keeping your mouth open for a long time. So, you know, patients like after you’ve prepped [01:28:50] everything, put them in temps are feels a bit weird. Got this. You know, occluding on one side.

Payman Langroudi: How much have you gone into occlusion? [01:28:55]

Alex Hadley: Um, well, I’ve done a couple of days with, um, with [01:29:00] Riaz. So, um, I know, you know, ash. [01:29:05] Ash teaches very similar stuff. T scan, uh, protrusive excursions, [01:29:10] like lateral excursions, you know, protected, mutually protected occlusion. Um, [01:29:15] and then and then, uh, like different. So I think you learn [01:29:20] an incredible amount about occlusion doing composite veneers if [01:29:25] you, if your occlusion is is not, is not working in composite. [01:29:30] First of all, say if the patient doesn’t tolerate it very well, you can get rid of it, which is great. But that is so [01:29:35] infrequent. I got that very, very, very infrequent. Um, and [01:29:40] then you can, you can dull dull patients in on threes and fours to get a little bit of. Oh yeah. [01:29:45] Yeah. So like if you don’t have enough occlusal like incisal space into incisal space and they don’t want ortho. [01:29:50] So yeah, you can learn an awful lot about occlusion doing [01:29:55] composite veneer cases. Um, yeah. And then um, and then t [01:30:00] scan and making sure you’ve got a good, a good like TMJ assessment, you know, [01:30:05] make sure there’s a good record of like, what you’re doing, why you’re doing it. If you’re doing a wear case [01:30:10] record what the wear index is or, you know, have your photos and your scan chat [01:30:15] with the patient. You know, they’ve got to know that there’s you know, some people don’t tolerate having the, you know, [01:30:20] the teeth increase in length. But yeah, it’s I mean, you can you can do things [01:30:25] carefully. Right. I know some I know some, some, some dentists are really like they [01:30:30] really like trialling things in composite and then prepping and putting ceramic transitional. Yeah. [01:30:35] I’m not a big I’m not big on that. Not big on that. Just like unnecessarily stretching [01:30:40] the the patient’s already long treatment out.

Payman Langroudi: Lots of precedents [01:30:45] going that way though I’ve noticed that. Yeah. Um, let’s move on to outside of [01:30:50] work. If you had a I mean, you’re very busy guy, man, but if you had a day off. [01:30:55] Yeah. No expectation on you. Yeah. What would you do? Come do.

Alex Hadley: A podcast. [01:31:00] No, no, I work. Yeah I know. Um, no. What do I do? [01:31:05] Um, I’m big into kite surfing. Oh, really? I like kite surfing. Yeah. And [01:31:10] do that in Southend and abroad. In the cold. In the cold. Yeah, [01:31:15] yeah, yeah.

Payman Langroudi: Where’s the best place you’ve ever done it?

Alex Hadley: Oh Cape Town.

Payman Langroudi: Oh really?

Alex Hadley: Cape [01:31:20] Town really cool. Yeah. Egypt’s pretty good. Very windy. Right? Yeah. You just need. Yeah, it just needs to [01:31:25] be windy. Yeah. Um, and I also have a powerboat that I like to take [01:31:30] my mates and my dad out on. Oh. Nice for lunch. Yeah. In Southend. Um, in, [01:31:35] uh, it’s kept in, uh, Burnham like around there on, on the Crouch. Um, so [01:31:40] that’s quite fun in summer. But yeah, we’re a bit unlucky with weather in the UK. We don’t get [01:31:45] that much time. Yeah, it was a bit of an impulsive.

Payman Langroudi: Kitesurfing looks extraordinarily difficult. Is it? Very [01:31:50] hard. It’s the. I think.

Alex Hadley: It’s easy. No, I’ll tell you what’s difficult. Surfing is difficult. Surfing is really difficult. [01:31:55] Like reading like waves and and and like picking your picking the right moment, [01:32:00] positioning yourself in the right place. But yeah, I do. I love water sports. I grew up sailing dinghies, [01:32:05] um, racing them around the Thames Estuary. That’s, you know, where I spent, [01:32:10] you know, most of my free time. I wasn’t at school. Um, and. Yeah, it [01:32:15] was. Yeah. So I think, um. Yeah. Kitesurfing. You. I mean, it depends what? Your experience [01:32:20] of sailing. Have you done any sailing? So if you understand, do you understand the physics [01:32:25] of how it works? Yeah, I remember I was at Bard, I was talking to Basil about because I’d just come back from [01:32:30] Cape Town. Uh, and, uh, I told him. Yeah, I told him I was, I was in Cape Town doing [01:32:35] kitesurfing. And, you know, I could see he was like, right. How does that work then? I was like, well, you [01:32:40] know, you generate lift by to use second nature. Yeah. By like steering the kite [01:32:45] and by changing the angle of attack of the kite, you know, you can you can build. It’s like using a clutch in a car, [01:32:50] you know that. But I could see I could see his brain like, you know, he’s like, you know, the mechanics [01:32:55] of, like, oh, how does that work? How does kite surfing work? Um, interesting. [01:33:00]

Payman Langroudi: Let’s move on. We’ve come to the end of our time. Let’s move on to the final questions. Fantasy [01:33:05] dinner party. Three guests, dead or alive, who would you have? [01:33:10]

Alex Hadley: Um, so I’ve heard you ask this question a few times. Yeah. Um, [01:33:15] I it was quite an easy. It’s quite an easy answer for me. Yeah, I think so, [01:33:20] because I, I um yeah, I so my, so [01:33:25] both, both grandfathers who are no longer with us. [01:33:30] Uh, and a great grandfather who I never met. Oh. Um, [01:33:35] just interesting group of guys who I don’t get to talk to, who [01:33:40] I think would be interested in in the kind of stuff that I’m doing now, but more, more. So I’d be interested [01:33:45] to hear about their experiences.

Payman Langroudi: Um, you did meet both grandfathers? [01:33:50]

Alex Hadley: Yeah. Yeah. So, um. Yeah, my maternal grandfather, um, [01:33:55] was diagnosed with dementia at 68, and it was like, a pretty nasty decline. [01:34:00] Um, and but he was he was a painter and decorator. [01:34:05] Had some businesses in Essex. Um, yeah. I think that’s where some [01:34:10] of the manual dexterity comes from. Or like the, you know, but also maybe like, uh, sometimes [01:34:15] if I’m a bit short with someone or like my terrible driving, like, you know, some traits that I think potentially [01:34:20] genetics can account for. Um, and then my paternal grandfather [01:34:25] was raised in an orphanage in Birmingham. Wow. [01:34:30] In the got to be the 40s. And then his mother took him back when he was [01:34:35] 11, when he was old enough to to work. So he worked in a worked in a factory in Birmingham, [01:34:40] did A-levels at night school. So, you know, 12 hour shift, then night [01:34:45] school. Uh, then became a petroleum engineer for BP. And I made [01:34:50] a real success of himself. So, you know, it’d be really interesting to talk to him about that. He was quite, a quite [01:34:55] a private guy. Um, how.

Payman Langroudi: Old were you when? When both of them passed? [01:35:00]

Alex Hadley: Um, well, one more recently than the other. So one kind of five years ago, I [01:35:05] think I’m pretty terrible with dates. And then the other about about ten years ago. Um, [01:35:10] and then my, my great grandfather, uh, [01:35:15] actually they lived not far, lived in Romford, like in Gidea Park, not not far from where the where [01:35:20] the practice is now. And um, he so he interesting [01:35:25] story. So he, he was an airman in, um, World War two and [01:35:30] he, um, he, he went, like, absent without leave [01:35:35] because his mum couldn’t afford rent. So he, you know, took himself [01:35:40] from France back to London and was, um, was kind of humiliated [01:35:45] by, you know, he was a man who was, you know, in London, not at [01:35:50] war. And he was, you know, he took whatever kind of social stigma that, that had. [01:35:55] Yeah. Um, and I think, I think he was kind of, uh, almost [01:36:00] a bit punished for it, um, post post war as well. So I mean, he [01:36:05] went back to he went back to the war and then, um, I think afterwards there’s something [01:36:10] I’ve spoken to. I have some Californian families of my, you know, have some cousins and, [01:36:15] um, that we’re related by, you know, by the same, same, same kind of tree. And they [01:36:20] said, um, they think he might he might have been, um, kind of tax [01:36:25] dodging around then because he didn’t want to be, you know, penalised heavily for kind [01:36:30] of having left without, without leave. So he was a I think he was an illegal bookie. [01:36:35] What a character. Yeah. In the East End. Um, so yeah. Really interesting guy and I think [01:36:40] I yeah, he, he died I believe like either the, it was either the year I was born or, or, [01:36:45] you know, just before, um, so yeah, it would be really interesting to see. Is that your mum’s [01:36:50] dad. That’s my, my mum’s, my mum’s. Mum’s. Your mum’s grandfather. Yeah. My mum’s [01:36:55] grandfather. Yeah yeah yeah yeah. Interesting guy. Yeah. So so those. Yeah [01:37:00] those Those. Those three guys. Amazing. And I don’t. I can’t think of anyone else I’d rather, you know, [01:37:05] catch up with.

Payman Langroudi: But our final question, it’s a deathbed. If [01:37:10] you had to leave three pieces of advice for your loved ones, what [01:37:15] would they be?

Alex Hadley: So this I haven’t really thought about, [01:37:20] but I think I think, um, I would probably give similar advice to the advice that [01:37:25] served me pretty well so far. Um, so [01:37:30] being be honest, don’t lie to people. Try [01:37:35] your best at everything because it doesn’t matter. Like whether [01:37:40] whether you, um, whether you perform like to the standard that you [01:37:45] set yourself. As long as, you know, you try your best, nobody can ask anything [01:37:50] more of you. Um, and the third, I guess, just, like, have fun. Do [01:37:55] do some other stuff, you know, don’t, don’t, don’t get bogged down in, like, the the minutia, there’s, [01:38:00] you know, there’s there’s cool things, there’s cool things to do and people to see.

Payman Langroudi: I’m [01:38:05] gonna I’m gonna throw out a couple of quickfire. Best [01:38:10] course you’ve ever been on.

Alex Hadley: Best course. I can’t give you a quickfire, I [01:38:15] don’t know, I learned different things from all of them. Our best course. Um, he’s [01:38:20] a great speaker. Uh, and, like a good friend, Rob Moretti. Hard and soft tissue grafting. [01:38:25] Yeah. Any any any implants.

Payman Langroudi: Of course, you’re desperate to go on. Or [01:38:30] you could click your finger and get yourself in that course right now. What would you [01:38:35] do?

Alex Hadley: I don’t know, after seeing Paolo last week, it’s got to be one of Paolo’s. Yeah, I’m sure, I’m sure if that man runs [01:38:40] a soft tissue grafting course, like, get me on it. Um, yeah. Oh, actually, [01:38:45] no. Yeah. So I’m. I’m, uh. So, uh, I’ve kind of run out of [01:38:50] UK courses now. Zucchelli zucchelli soft tissue grafting. Yeah, just like down the rabbit hole. [01:38:55]

Payman Langroudi: Um, favourite book?

Alex Hadley: Favourite non-fiction or fiction? I’m pretty, I’m [01:39:00] pretty bad with. With fiction books I get distracted. Yeah. Um. Favourite [01:39:05] book? Don’t have one.

Payman Langroudi: Dental book?

Alex Hadley: Oh, [01:39:10] I don’t know. At the moment, I’m flicking through Zooey Kelly’s, uh, mucogingival [01:39:15] surgery. Yeah.

Payman Langroudi: Bit of kit.

Alex Hadley: Favourite bit of kit? Um, [01:39:20] the get out of jail kit. The neo biotech fixture [01:39:25] removal? Yeah.

Payman Langroudi: Favourite practice in the UK that you [01:39:30] don’t work in?

Alex Hadley: Favourite practice in the UK? I don’t work in. Well, [01:39:35] I mean, coolest practice I’ve seen is pools, [01:39:40] right? It’s just this state of the art practice. Have you seen it? No. Oh, it’s like [01:39:45] an like the operating. The the surgeries are built like operating theatres, right? They’re all on an overpressure. [01:39:50] Everything’s like very. It is the his definition. [01:39:55] It’s the definition of of sterile. Right. Or like, you know, sterile environment. [01:40:00] There’s no where is it? It’s in Thorpe Bay, right around the corner from where my parents live. Oh, yeah. Okay. [01:40:05] Yeah. It’s, um. Yeah, on the sea front. So. Yeah. That’s cool. But, I mean, that’s specialist practice. That’s right. [01:40:10] I’m not going to be in there. Think of another one. Think of another one if you want. Well, [01:40:15] I’ve heard big things about Andy. More advanced, but I’ve not seen it. And I’ve not met Andy. [01:40:20] Yeah. What a guy. Yeah. That’s cool. Yeah. You should put me in touch with him. That’d be cool. [01:40:25] Just to have a chat with him.

Payman Langroudi: Yeah, he’s a good guy.

Alex Hadley: Yeah, I’ve heard he’s into it. Yeah, yeah yeah, yeah. [01:40:30] He probably goes. Probably goes, like to warm places. It might be a bit more. Well, he’s.

Payman Langroudi: Friends with Branson. [01:40:35] So they go. They go on that island BVI.

Alex Hadley: Yeah.

Payman Langroudi: Well, well Branson [01:40:40] is friends with the guys from Google. Okay. So the guy from Google has a huge kite [01:40:45] surfing event that he does every year. Yeah, yeah. On another island?

Alex Hadley: Yeah. No, I think Branson did. Uh, Branson [01:40:50] did a kite surf across the English Channel. There you go. Yeah, he did like the [01:40:55] kite foiling and stuff. You need to get into that.

Payman Langroudi: He’ll like you to. It’s been a massive pleasure, man. You got. You [01:41:00] got a wise head on your young shoulders. But keep going, keep going. Yeah, and keep enjoying. [01:41:05] Yeah.

Alex Hadley: Thank you. Thanks for having me.

Payman Langroudi: Pleasure.

[VOICE]: This [01:41:10] is Dental. Leaders the podcast where you get to go one on one [01:41:15] with emerging leaders in dentistry. Your [01:41:20] hosts, Payman Langroudi and Prav Solanki.

Prav Solanki: Thanks [01:41:25] for listening, guys. If you got this far, you must have listened to the whole thing. And [01:41:30] just a huge thank you both from me and pay for actually sticking through and listening to what we had to [01:41:35] say and what our guest has had to say, because I’m assuming you got some value out of it.

Payman Langroudi: If [01:41:40] you did get some value out of it, think about subscribing. And if you would share [01:41:45] this with a friend who you think might get some value out of it too. Thank you so, so, so much for listening. Thanks. [01:41:50]

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

Dooroo Ihm: I think 90% of patients who doesn’t like to have a little bit brighter [00:00:05] teeth. Yes, everyone does, but sometimes they’re they don’t [00:00:10] mention it to you because they only met you for the first time. Yeah. I mean, I think that’s another [00:00:15] difficult part. You’ve got to listen to the patient. Like on the first day of meeting [00:00:20] someone, they’re not.

Payman Langroudi: Going to open up.

Dooroo Ihm: Fully. They’re not going to open up. And then if you open up too [00:00:25] much, putting the shade next to the, you know, patient’s tooth, [00:00:30] they probably might get a little bit, you know, step back and then thinking why? [00:00:35] Why? Because I’m not here for this. Yeah. You know that’s also part [00:00:40] of listening. You know, they’re here to get their teeth clean and [00:00:45] then you want to give them what they want. And then you [00:00:50] let them decide. I think I think that’s probably my key.

[VOICE]: This [00:00:55] is Dental Leaders [00:01:00] the podcast where you get to go one on one with emerging [00:01:05] leaders in dentistry. Your [00:01:10] hosts Payman Langroudi and Prav Solanki.

Payman Langroudi: It [00:01:15] gives me great pleasure to welcome drew him onto the podcast. [00:01:20] Drew’s a dentist I met a year or two ago at [00:01:25] Banning Dental when I came over to train the team there, and, um, [00:01:30] I was particularly impressed with the the way that you were talking both to patients [00:01:35] and to me. And you’ve got an interesting story, but good, good to good to have you on the podcast, by the way. [00:01:40] Welcome. Thanks for coming all this way.

Dooroo Ihm: Thank you very much for having me. Payman. Um, it’s it’s [00:01:45] my honour to be here and have a chat with you and then talk about the journey of dentistry. [00:01:50]

Payman Langroudi: Yeah. So you were born in South Korea? Yes. And your dad’s [00:01:55] a dentist?

Dooroo Ihm: Yeah, My entire family is dentists. My dad, uncle, [00:02:00] also my older brother. He’s also in the UK. He works [00:02:05] as a dentist as well.

Payman Langroudi: What would you say is the main [00:02:10] difference between dentistry there and dentistry here?

Dooroo Ihm: I think the dentistry in back in South [00:02:15] Korea is a it’s not as busy as a UK [00:02:20] dentistry because.

Payman Langroudi: Is it all private.

Dooroo Ihm: It’s a bit of a mix [00:02:25] because the it’s kind of NHS involved private. So patient [00:02:30] pays a certain amount. The government pays the clinics a certain amount. [00:02:35]

Payman Langroudi: Now the price is fixed.

Dooroo Ihm: Yes. So um it’s [00:02:40] very similar to Swedish like it’s well looked after. [00:02:45] Um, so there isn’t actually much work to be done really? Like from [00:02:50] the child care, they always go to dental clinics.

Payman Langroudi: So prevention is.

Dooroo Ihm: Yes. [00:02:55] Case, prevention is a really, really key thing in South Korea and its [00:03:00] easy access. And I think that also makes the oral health care [00:03:05] very, very good standard in South Korea. Um, when my dad started [00:03:10] working, obviously that’s 32 years ago, a lot [00:03:15] of work, a lot of work, but now not not [00:03:20] so much.

Payman Langroudi: So we get this sort of image of South Korea from here of like a very high tech, [00:03:25] very prosperous place. Is that the same in dentistry like other [00:03:30] practices or super duper and does it do dentists do well better [00:03:35] out there than they do here? Or what’s your what’s your feeling on all of that? I think I.

Dooroo Ihm: Think in a sense, [00:03:40] you know, because the it high tech, um, it also helps the dentistry [00:03:45] quite a lot because usually the crowns or any [00:03:50] prosthetic work to be made is within a day.

Payman Langroudi: Oh, really?

Dooroo Ihm: Like, you [00:03:55] prank the tooth and you take an impression. And someone from the lab picks it up. And [00:04:00] within an hour, they bring the crown.

Payman Langroudi: Wow.

Dooroo Ihm: Like an hour or two? Like so. [00:04:05]

Payman Langroudi: And then you bring the patient back in that afternoon. Yeah.

Dooroo Ihm: And then fit it in straight away.

Payman Langroudi: And [00:04:10] that’s a standard thing. Mhm. Wow.

Dooroo Ihm: And also we don’t really have that many [00:04:15] clinics in South Korea as far as I know. Do you know appointment based. [00:04:20] It’s all walking. Oh really. Yeah. Even my dad’s and my uncle [00:04:25] clinics, they’re all walking. So it’s easy access for people [00:04:30] to get their teeth checked whenever they have time. Mhm. Um, there are [00:04:35] clinics who purely work as appointment based specialisations and [00:04:40] these things, but it’s usually really easy access even in other parts [00:04:45] of the healthcare as well.

Payman Langroudi: And what is the the South Korean sort of demeanour. [00:04:50] Because the reason I asked this question is because I go to trade shows a lot, [00:04:55] right? So go to international trade shows a lot, and there’s always a huge [00:05:00] South Korean contingent. You know, obviously big manufacturing country [00:05:05] for even for Dental. Right. Yeah. And whenever I’ve hung out with the Koreans, they’re all party [00:05:10] animals, man. Are they real party animals? They remind me of the Iranians [00:05:15] in that sense, you know. Really? Am I wrong about that? Is it only [00:05:20] on on holiday? It’s all right on holiday. Is it like that?

Dooroo Ihm: I mean, I’ve never actually [00:05:25] thought about it in that sense.

Payman Langroudi: I mean. The [00:05:30] ones I’ve come across. Maybe I’m just coming across those guys.

Dooroo Ihm: I think you were attracting different people. [00:05:35]

Payman Langroudi: Yeah. Maybe. Yeah. No. You haven’t thought that? No, [00:05:40] no. So then at 16, you went to Berlin? [00:05:45]

Dooroo Ihm: Yes. At 16, I was sent to a [00:05:50] boarding school in Germany. In Berlin. Why? Um. Purely, [00:05:55] I think. I think my parents want me to study [00:06:00] in abroad. Knowing that there’s there’s a lot of subjects [00:06:05] to study in South Korea. Um, like, unlike the other [00:06:10] country. We’ll have to study every single subject, regardless whether you have [00:06:15] passion about science, science, art, history, art. And [00:06:20] they knew I had no interest. And then I wasn’t doing [00:06:25] so well in the school, in the subjects that I wasn’t passionate about. [00:06:30] And then my mom and dad had a thought about, why don’t we send [00:06:35] him somewhere that he can actually he likes the [00:06:40] systems of the educations. Mhm. And then they looked around, they [00:06:45] had a little help from one of the teacher who was half [00:06:50] Korean and half German. So she guided through some of the schools [00:06:55] in Germany, and she contacted one of the schools called PBIs. [00:07:00] That’s in Berlin. Um, it’s an international school. It’s [00:07:05] a private school, boarding school. And that’s where I was sent. [00:07:10] But obviously back then I didn’t speak a word of English and German. I [00:07:15] had to learn and survive. Really? Yeah.

Payman Langroudi: What was your reflection the first day you [00:07:20] got to Berlin? What was the thing that struck you as the most different people? [00:07:25] Yeah.

Dooroo Ihm: The way they.

Payman Langroudi: Look.

Dooroo Ihm: Yeah, the way [00:07:30] they talk.

Payman Langroudi: Yeah.

Dooroo Ihm: Everything was different. Everyone’s different. When you were 16, [00:07:35] you’re. You’re just scared.

Payman Langroudi: Yeah.

Dooroo Ihm: And you don’t know [00:07:40] where to start. And then what to do.

Payman Langroudi: There’s an international boarding school. So there was people from [00:07:45] all over the place. Absolutely anyone from Korea? No. You were the only one. Yeah. [00:07:50]

Dooroo Ihm: And there are lots of German as well. Yeah. Who wanted [00:07:55] to learn international.

Payman Langroudi: System.

Dooroo Ihm: Systems? Um, it was such a great [00:08:00] school, to be really honest with you, because I learned a lot from the [00:08:05] German schools that I went to. Um, also, being able to communicate [00:08:10] international people, you know, to understand different cultural. So [00:08:15] it was it was quite eye opening opportunity for me. But [00:08:20] at that time, when I went by myself, I hated it. [00:08:25]

Payman Langroudi: To start with.

Dooroo Ihm: I’m sure it was. It was suffering. Yeah. Because I didn’t [00:08:30] know whom I could communicate. There’s no one.

Payman Langroudi: How long did it take you before you could [00:08:35] understand what people are saying and all that?

Dooroo Ihm: The thing is, you know how a lot of people talk about on YouTube [00:08:40] or social networks, how they learn the language? Yeah. Me purely [00:08:45] took me six months. Somehow, six months [00:08:50] later, I could understand just bit by bit. [00:08:55]

Payman Langroudi: Is that immersion thing right? You live somewhere for six months. It’s better than studying in school. [00:09:00]

Dooroo Ihm: I don’t know how. You know.

Payman Langroudi: Osmosis?

Dooroo Ihm: Yeah. Theoretically works, [00:09:05] but six months later, I was talking to people. And [00:09:10] then that’s how. And then.

Payman Langroudi: And then you were studying for the, I guess, the German equivalent [00:09:15] of A-levels?

Dooroo Ihm: No, no, the international school was based on English. [00:09:20] Oh, I.

Payman Langroudi: Was studying English. Yeah.

Dooroo Ihm: So it was a level not.

Payman Langroudi: Not baccalaureate? [00:09:25] No. All right.

Dooroo Ihm: So I did A-level in, you know, all [00:09:30] the science because. But even at that time I was interested in [00:09:35] healthcare. Like not necessarily.

Payman Langroudi: You went from not speaking a word of English or German [00:09:40] to taking your A level. In what? Maths, physics, chemistry, biology, these sort of things. Yes. Within [00:09:45] two years.

Dooroo Ihm: Within two years? Yeah.

Payman Langroudi: You must have studied your butt off. Did you, [00:09:50] did you. Did you study really hard?

Dooroo Ihm: I had to. I mean, I had to I had to. [00:09:55]

Payman Langroudi: Sink or swim, right? Yes.

Dooroo Ihm: In order to survive. Really, it was just a survival. [00:10:00] Um, I hadn’t had any other choice at all. Yeah. [00:10:05]

Payman Langroudi: And then, just to make life even more interesting, you [00:10:10] went to study dentistry in Hungary? Yes. In Budapest?

Dooroo Ihm: No. In Debrecen. [00:10:15] Aha. It’s a small city, about two, 2.5 [00:10:20] hours away from Budapest. Um, when? When I finished [00:10:25] the schools in Germany around that time, my cousin and my [00:10:30] older brother were studying in that school.

Payman Langroudi: And [00:10:35] so parents thought.

Dooroo Ihm: Yeah, it’s easier and safer. So I applied [00:10:40] and then got in and and.

Payman Langroudi: Was that course in English or was that it was in English. But [00:10:45] you had to learn a bit of Hungarian. Right, to treat the patients.

Dooroo Ihm: Yes, absolutely. We had a Hungarian course [00:10:50] every year to learn and to just communicate just enough to, you know, [00:10:55] talk to the patients, because all the patients that we had, that was Hungarian patients.

Payman Langroudi: Well, then [00:11:00] you said you said you weren’t strong at the subjects that you didn’t like was languages one of those subjects? [00:11:05]

Dooroo Ihm: Absolutely. My Hungarian was awful.

Payman Langroudi: It’s funny.

Dooroo Ihm: I, [00:11:10] I think, you know, there’s a there’s what we call it bilingual and trilingual. [00:11:15] Um, I think my max was South Korean and English. [00:11:20] I hadn’t had any capacity to put any other language in my head. [00:11:25] So for me, German was gone out of equations [00:11:30] and Hungarian just didn’t have a space to put it in. Yeah, so [00:11:35] I had to just scrape through.

Payman Langroudi: But how did it? How was [00:11:40] hungry? Did you enjoy that time or.

Dooroo Ihm: I think if I think back, [00:11:45] it was it was it was just a journey. I mean, now, [00:11:50] if I think about it, being a student is better. Yeah. Yeah. [00:11:55]

Payman Langroudi: Yeah.

Dooroo Ihm: No responsibility. Yeah. Enjoy it for the time being. [00:12:00] Yeah.

Payman Langroudi: So then, straight out of Hungary. Where was the first [00:12:05] place you went to work?

Dooroo Ihm: I did actually go back to South Korea to work in [00:12:10] my dad’s clinics for a bit. Um, but then I got bored because, [00:12:15] like I said, the comparison to UK dentistry and South Korean [00:12:20] dentistry. Um, also, when you work in your [00:12:25] dad’s clinics, you don’t you don’t actually get, you know, tortured and [00:12:30] bullied to work hard. It’s, you know, it’s given. So [00:12:35] I packed a suitcase one night, and then I told my parents, I’m going [00:12:40] to. I’m actually going to Ireland. And they were shocked because [00:12:45] I could just stay in South Korea and work. Um, then I moved to Dublin. [00:12:50] I didn’t have a job back then.

Payman Langroudi: Why Dublin?

Dooroo Ihm: Um, because to be really honest [00:12:55] with you, I always it was my passion to move to UK because, you know, when I [00:13:00] went to German boarding school, we went to the school trip to London, [00:13:05] and I was I was amazed by [00:13:10] the London, you know, near the banks where the same poor city. Yeah. [00:13:15] Millennium bridge. Yeah. And Tate Modern.

Payman Langroudi: Just the way it looked. Yeah.

Dooroo Ihm: Just [00:13:20] the way that it looked. I mean, when I was 16 and I thought to myself. And I said to myself, [00:13:25] one day I’m going to come and work here no matter how long it [00:13:30] would take. I’ve come. So I looked up. How do I [00:13:35] gain the GDC license and come and work. But the thing is, before Brexit they [00:13:40] had a lot of rules and regulations. Even though my diploma [00:13:45] was qualified in the EEA because I’m not European, I couldn’t come and work. [00:13:50] So I thought, where can I possibly go and work? And [00:13:55] in, in English, because like I said, that’s, that’s the [00:14:00] my capacity. I can’t learn another language. Yeah. And [00:14:05] that was a Dublin in Ireland.

Payman Langroudi: As in you found [00:14:10] a job there. No. But why Dublin? Like just because it’s English speaking. Yeah, I [00:14:15] know, but why not London? No.

Dooroo Ihm: Like, obviously I had to work elsewhere [00:14:20] before I gained a GDC license. Oh, I see, I see. Yeah. So the only place [00:14:25] that I could start work straight away without any exams or any further [00:14:30] paperwork was the Republic of Ireland.

Payman Langroudi: Before [00:14:35] we go any further, do you have like an outsider mentality? [00:14:40] Because you could have continued in is it soul? Yeah. [00:14:45] You could have had a really successful life in soul. Your dad, your uncle, [00:14:50] all those people fully connected. You could. You could have had. It’s a great country. It’s not like. It’s not like a [00:14:55] country you have to run away from. Like like like many of us. Well, [00:15:00] you know, like. Okay. Yes. You like, you like the idea of of of living abroad. [00:15:05]

Dooroo Ihm: I think it’s if you if you lived most of your life outside [00:15:10] of the country where you’re born, I think you.

Payman Langroudi: Don’t fit in anywhere. [00:15:15] Exactly.

Dooroo Ihm: Well, when I went back home, I mean, I still love everything about South [00:15:20] Korea. Yeah. And, you know, when they play match, it’s just, like, touching. But [00:15:25] when you when you actually move back for having [00:15:30] a such a long period of gap.

Payman Langroudi: You’re different somehow.

Dooroo Ihm: It’s just you don’t really blend in [00:15:35] and you don’t feel like I fit in here. And that’s. That’s how I felt [00:15:40] every day in the life.

Payman Langroudi: It’s so interesting, you know. How long does it take for that to happen? [00:15:45] Because I, we have loads of people from all over the world that work, work here. And I always talk to the ones [00:15:50] who are five years out of their home country. And it’s such a difficult time, [00:15:55] five years out, because you don’t fit in here and you no longer fit in back home [00:16:00] either. And it takes a little bit longer than that to fit in here, to feel like this is home.

Dooroo Ihm: I think I [00:16:05] lived away from home about. Well, around that time was probably [00:16:10] 12 years or so. It’s a fairly long time. Yeah. [00:16:15] So that’s that’s probably another reason why I’ve decided. Yeah. Why don’t [00:16:20] I give it a try? But probably back in my mind thinking that, you know, I can [00:16:25] always go back home.

Payman Langroudi: Did your parents sort of say don’t go?

Dooroo Ihm: No. My [00:16:30] my mom and dad. They they on like literally on that day me leaving. [00:16:35] I remember my parents saying, if you need to come back, come back any time [00:16:40] because you can. And I said, yes, I will. But obviously [00:16:45] in my mind I said, no way.

Payman Langroudi: How many kids are you?

Dooroo Ihm: Uh, I’ve got [00:16:50] me and my older brother stuff, man.

Payman Langroudi: You know, now that I have a kid, if my kid said, [00:16:55] I’m off to South Korea to work and live, I mean, I’d be happy for him [00:17:00] from a career perspective. Yeah, but it’s tough. Must be tough for your parents. Must be. [00:17:05] How often do you go back? Every year.

Dooroo Ihm: No.

Payman Langroudi: It’s tough man.

Dooroo Ihm: Every probably [00:17:10] 4 or 5 years. Whoa. But the thing is, I always ask them [00:17:15] to come around and pay visits. Yeah. And then take some time off from. [00:17:20]

Payman Langroudi: So they do come here?

Dooroo Ihm: Yeah. My mom been here about what, 4 or 5 [00:17:25] times already. So. But my dad is a workaholic. He works six days a [00:17:30] week. Till now he’s been working. Is he a general dentist? [00:17:35] He’s a general dentist, but he mainly focuses on implants and sinus liftings. [00:17:40] So complex implant cases. Um, he’s been doing it 30, [00:17:45] 35 years, and he said he’s got another 15 years to carry on, [00:17:50] but I tried to stop him. All right.

Payman Langroudi: Let’s talk about Ireland, then. [00:17:55] What kind of practice was that?

Dooroo Ihm: Yeah. So I went there. I booked an Airbnb [00:18:00] for about two weeks, and I thought, how hard can it be finding [00:18:05] a job, you know? And I printed my CV about 100 copies. [00:18:10] And then within that, the radius [00:18:15] that I could walk to, I walked around probably with [00:18:20] a little bit of exaggeration. I probably walked around about 200 practices [00:18:25] and start handing in my CV.

Payman Langroudi: Physically.

Dooroo Ihm: Physically? Yeah. Because [00:18:30] what’s the point if I’m there? Might as well. Yeah. And then one practice [00:18:35] called me back saying, do you want to come? Like I had a few interview like straight [00:18:40] away, but nothing was really promising because even then, like [00:18:45] I had Irish Dental Council number, which is very similar to GDC, [00:18:50] but then even then I had to wait for my visa in [00:18:55] order to work, which was another hurdle that which I didn’t actually see through. [00:19:00] And then there’s another practice in slightly north Dublin. [00:19:05] Um, he’s Irish guy. He called me saying, come for an interview during the lunch. [00:19:10] And then he casually he was just having [00:19:15] lunch and then he stopped talking to me. And then he goes, what do you want to stop? [00:19:20] Nice. It was it was kind of like Almost. [00:19:25] I’ve been there for seven days. And then I thought, what’s the chances? Do I need to go [00:19:30] back home or do I need to go to, I don’t know, America? Because [00:19:35] by that time my brother was actually in LA. Uh, he [00:19:40] was doing the restorative course in UCLA. Oh, nice. So he said [00:19:45] to me, come and, you know, stay and then let’s just work in America. So [00:19:50] I was kind of on the borderline of, shall I give up on, you know, the UK Island [00:19:55] of Dreams. And then he goes, yeah, I like it. [00:20:00] Let’s start.

Payman Langroudi: Nice.

Dooroo Ihm: And then I just ask him, like, is that how you give the job? And [00:20:05] I said, yeah, I mean if I like someone yeah I will. And that’s how I got a job. So [00:20:10] I got all the paperwork done and started working in the middle of Covid, [00:20:15] really in the middle of Covid. But the thing is another [00:20:20] probably in a, in a probably lucky sense that, Ireland didn’t [00:20:25] have any much of restrictions of working in dentistry.

Payman Langroudi: Oh, really? Not like.

Dooroo Ihm: Here. Yeah, [00:20:30] we didn’t have to shut down the clinics, but there are some clinics they actually closed down [00:20:35] for their health reasons and for the safety reason. So [00:20:40] we had a lot of patients and he was quite [00:20:45] a reputable dentist in Dublin. So he had a large [00:20:50] patient volume. So it was lucky for me to gain [00:20:55] that such a crazy amount of experience in that short [00:21:00] one year. Um, it was probably the best [00:21:05] mentor I ever had in my life, and I still think he is one of [00:21:10] the best dentists that I look upon. When you think.

Payman Langroudi: Back [00:21:15] on what you learned from him. Mhm. What are the couple of things that sort of stick [00:21:20] out for you?

Dooroo Ihm: I think the the message that he [00:21:25] was trying to give it to me was, listen to patients, why they’re here [00:21:30] and what you can do for them. And just listening [00:21:35] to the patient is the most important things. And he was probably [00:21:40] very caring person. So he always put patient [00:21:45] first regardless of what happens. And I think it [00:21:50] was a good start for me because, you know, when you when you start in dentistry [00:21:55] in, in the first year, you could pick up different things. [00:22:00] Yeah.

Payman Langroudi: I think your first boss is a massive, massive thing, huge impact. [00:22:05] It sets you on a particular direction. Yeah.

Dooroo Ihm: So he was very humble. [00:22:10] Um, he was very skilled dentist. But then he was a caring [00:22:15] dentist. So for me, I had a lot of skill sets [00:22:20] that I wanted to pick up from him. And surprisingly enough, he [00:22:25] never, ever taught someone like among his associates because there [00:22:30] are quite few dentists working for him. He never, ever taught them. [00:22:35] He because he didn’t need to and he didn’t want to teach them. But then [00:22:40] he tortured me for about two months, and [00:22:45] I hated him, to tell you the truth. I hated it, I hated every [00:22:50] single day going to work because I’ll get told off any [00:22:55] any work that I do. It’s not good enough. [00:23:00] But then two months, I. I listened to him and [00:23:05] I tried to improve it. And then two months later, he came [00:23:10] up to me saying, you’re listener. You can handle the pressure [00:23:15] now. I’ll teach you. And then the my whole [00:23:20] journey started differently. I’ve learned from his oral surgery [00:23:25] skill sets because he got MSC in Oral surgery implant. [00:23:30] He’s done orthodontics and [00:23:35] he’s done facial aesthetic well. So he does. [00:23:40] I mean, I haven’t really come across someone who does fixed braces and Invisalign and [00:23:45] implants oral surgery. So I learned really a lot [00:23:50] from him Foundation skill sets. And then a year after. [00:23:55]

Payman Langroudi: How old was he?

Dooroo Ihm: He was only 49.

Payman Langroudi: Shout him out. [00:24:00] Who is this hero? What’s his name? Sean.

Dooroo Ihm: Sean?

Payman Langroudi: Yeah. What’s his surname?

Dooroo Ihm: Not [00:24:05] too sure. He would like to be mentioned.

Payman Langroudi: Of course he would.

Dooroo Ihm: Sean Murray.

Payman Langroudi: Excellent. [00:24:10]

Dooroo Ihm: Um. I still look after his nephew. His [00:24:15] nephew came to London and there was still part of family now. Love [00:24:20] that. Yeah.

Payman Langroudi: Love that. So why did you leave? Because you had still this dream [00:24:25] of London.

Dooroo Ihm: Yes. And also by [00:24:30] that time I had a girlfriend that I was seeing for about [00:24:35] ten plus years, and she wanted to [00:24:40] move to UK.

Payman Langroudi: Ten years. So since Korea. Yeah. [00:24:45] Okay.

Dooroo Ihm: Yeah. So we got to know each other from back home. [00:24:50] And then she actually came to the Hungary to do the medical schools. [00:24:55] Oh. So yeah, we spent a lot of time together. And [00:25:00] then it was on the process of okay, we’ve got to settle [00:25:05] down together and then where should we go? Um, I was comfortable, [00:25:10] happy in Dublin.

Payman Langroudi: But was she in Dublin as well.

Dooroo Ihm: Yeah, [00:25:15] she, she came to Dublin a few times while she was still studying. And [00:25:20] then it was kind of our decision okay to move to the UK [00:25:25] a little bit earlier. So that’s when we decided to move to UK. [00:25:30] So she’s.

Payman Langroudi: A doctor?

Dooroo Ihm: Yes. And that’s the time when the Brexit. [00:25:35] Allow me to come and work straight away. [00:25:40] So that opportunity when.

Payman Langroudi: You say Brexit allowed you to come. [00:25:45] I would have thought Brexit would have made it harder.

Dooroo Ihm: No, it would have made it harder. But because of the Brexit [00:25:50] and GDC, what they have changed in terms of rules and regulations [00:25:55] is anyone who’s got a diploma can come and work. [00:26:00] But before Brexit it was. Oh, I see.

Payman Langroudi: They did that to cover the fact that they’re going [00:26:05] to lose people.

Dooroo Ihm: Exactly. Yeah. Before then it was European plus. [00:26:10] Yeah yeah, yeah. Aeaeeé diploma. I get but they’ve changed to just looking [00:26:15] at, you know, your degrees and diploma. So that’s how I could [00:26:20] apply it. Um.

Payman Langroudi: So you decide you’re coming to London. Did [00:26:25] you find a job before you came? Or did you do your same? [00:26:30]

Dooroo Ihm: No. From Dublin. Dublin? I had to, I had to apply. Many, [00:26:35] many places. And it was it was a straight after Covid, so it was [00:26:40] very difficult to find a job. Yeah. Um, so I found a job in Cambridge first, [00:26:45] and then I worked there for about a year and a half. And [00:26:50] then I found. Was it a mixed practice? No, it was a private practice. Oh, lovely. Yeah, [00:26:55] it was. It was a good practice. I liked it, actually.

Payman Langroudi: In that period, there was just many patients with money [00:27:00] in their pockets. Right. Yeah. That was that was the golden age. There was a lot of work, [00:27:05] the valuations that people were talking about back then. Yeah. So you were busy. [00:27:10]

Dooroo Ihm: Very busy.

Payman Langroudi: Ppe and all that stuff. That was past that. Was it.

Dooroo Ihm: Partially. [00:27:15]

Payman Langroudi: Oh, yeah.

Dooroo Ihm: We had a what.

Payman Langroudi: Was that thing where the room has to settle. Oh, what was [00:27:20] that called? All these new words we learned. Fallow time. Yeah.

Dooroo Ihm: You [00:27:25] have to empty the room for about two hours after it was all.

Payman Langroudi: Yeah. [00:27:30] All those words we learned. Yeah. So. All right. So. So you worked there. Were you happy there?

Dooroo Ihm: Yeah, [00:27:35] I was happy in Cambridge, but the Cambridge was a little bit too quiet for us [00:27:40] as a town. Yeah, it was after after work. There’s nothing going on. It [00:27:45] was very quiet.

Payman Langroudi: Did you not sit by the water and. Yeah. I suppose you can’t do that for [00:27:50] long. No.

Dooroo Ihm: And then we looked about. Okay, why don’t we move to [00:27:55] London? Yeah. And then that’s where I found Betty. And [00:28:00] that’s currently I’m working for two years.

Payman Langroudi: So banning Dental for [00:28:05] someone who doesn’t know. Mhm. I mean obviously I’m very aware of them. They [00:28:10] correct me like, tell me, tell me, how many practices is it now?

Dooroo Ihm: They’ve got ten [00:28:15] branches now.

Payman Langroudi: Yeah. Ten huge practices. Yes. And [00:28:20] from squat.

Dooroo Ihm: From squat.

Payman Langroudi: All of them. Yeah. That’s that’s the business model and [00:28:25] super duper beautiful places.

Dooroo Ihm: It’s it’s probably really [00:28:30] one of the best or the luxury practices. Nice looking. Yeah. Nice looking. [00:28:35] It’s not too much. It’s it’s a nice and tidy up. It’s [00:28:40] very elegant looking practice. Yeah. And the equipments is very, very [00:28:45] up to date. Yeah.

Payman Langroudi: And and the systems, the people, the way they follow up and [00:28:50] all that. Right.

Dooroo Ihm: System really, really works. I mean probably that’s the reason I’m still [00:28:55] there and the working happy in two years and their system is great. Marketing [00:29:00] teams and follow up team. You know how the the appointments are managed [00:29:05] is properly nicely designed. They spent a lot of time I see I [00:29:10] see the practice owner pretty much working seven days a week.

Payman Langroudi: Yeah, yeah, [00:29:15] yeah. They’re hard working guys.

Dooroo Ihm: Yeah they are.

Payman Langroudi: Yeah. And so in [00:29:20] amongst all of this, you also studied endo. [00:29:25]

Dooroo Ihm: Yes, I’ve done two years. Endo. I [00:29:30] signed up for the. Where was.

Payman Langroudi: That? Where was that?

Dooroo Ihm: Msc in OSU in Birmingham.

Payman Langroudi: Oh in Birmingham. [00:29:35]

Dooroo Ihm: Yeah. But.

Payman Langroudi: Um, was it distance learning? Yes.

Dooroo Ihm: It was a part time distance [00:29:40] learning.

Payman Langroudi: And how much of it was hands on?

Dooroo Ihm: Quite a lot of hands on. [00:29:45] Really. Like the hands on was I think I was going into [00:29:50] the campus about four times a year, and each time [00:29:55] we’re spending an entire week in hands on practice treating patients.

Payman Langroudi: Yes. [00:30:00]

Dooroo Ihm: Treating patients, doing all the models, sort of mixed.

Payman Langroudi: Was this during [00:30:05] your Cambridge phase that you did there?

Dooroo Ihm: No, I actually started it in [00:30:10] from Dublin. Aha. So I had to travel. And [00:30:15] the first my mentor, he said to me, he suggested you need [00:30:20] to do some study. Like most people would find [00:30:25] it difficult to start in your first year of working. But then he said [00:30:30] to me, if you set your standard high, you will get through easily. Um, it was [00:30:35] difficult because in the first year everyone finds it difficult, like even just working [00:30:40] by yourself. But then I had to study at the same time, [00:30:45] but then carry it out and.

Payman Langroudi: Pay for it as well.

Dooroo Ihm: Absolutely, yes.

Payman Langroudi: How much does it [00:30:50] cost? I think ballpark. I [00:30:55] think it was.

Dooroo Ihm: Probably around 12 K a year. A year. Yeah.

Payman Langroudi: For [00:31:00] you did two years. But it could have been three, right?

Dooroo Ihm: Yes.

Payman Langroudi: Yeah. Bloody [00:31:05] old man. So. Yeah. That’s that’s that’s is that advice that you would give someone now like a young, [00:31:10] young dentist would you say do a distance MSC like are you, are you now very competent at [00:31:15] Endo.

Dooroo Ihm: Um, yes I am in, in one [00:31:20] of the branch in banning I purely do endo treatment.

Payman Langroudi: So you get internal referral.

Dooroo Ihm: Internal [00:31:25] referral.

Payman Langroudi: Let’s see. It’s a massive income isn’t it. Yes. It’s a massive income.

Dooroo Ihm: It’s [00:31:30] such a great to be able to, you know, provide that treatment [00:31:35] to the patients. Of course in one of the branch in Blackfriars we have [00:31:40] our specialist. Yeah. Um, I do refer to him mostly because I do, because, [00:31:45] I mean, he spent a lot more time purely dedicating land treatments, and [00:31:50] I want my patients to get better treatments. Not necessarily I [00:31:55] would provide worse treatments than him, but still, I feel much. He’s [00:32:00] the expert. Yeah, he’s the expert, so I’ll let him do the work. And then the [00:32:05] follow up treatments, I can take it on. So I think it’s working together [00:32:10] is important. But the thing about studying MSC on the sideway, [00:32:15] it’s not purely okay. I can provide that treatment plans and [00:32:20] I can do the treatment so I can generate more income. It’s also to be able [00:32:25] to provide a comprehensive treatment plan if you know what [00:32:30] can be done. Yeah. The thing is, before I’ve actually studied Perio [00:32:35] Endo, these many different fields, my [00:32:40] my treatment plan was so narrow and fixed. But [00:32:45] the more you actually know, not necessarily you’re going to do all of that [00:32:50] treatments by yourself. If you’ve got team members, fantastic. You work together, but [00:32:55] patient will go out from your surgery with [00:33:00] one of the best treatments ethical plan that you could possibly plan. [00:33:05] And I think that’s probably one of my advice to if someone can [00:33:10] afford to study at the same time in the young career, because it [00:33:15] will really, really help their career. It may not pay off, you know, [00:33:20] instantly, but in the long term it will definitely [00:33:25] give you the benefit.

Payman Langroudi: I mean, it’s a good point, isn’t it, because you think if you [00:33:30] study, you learn a new skill and then you can charge people for that skill? That’s [00:33:35] one way. But what you’re saying now, that’s another thing that people don’t consider sometimes, [00:33:40] you know, treatment planning comprehensively treatment planning. You know, just knowing what’s possible [00:33:45] is different to actually doing the work itself. It’s another very important skill. [00:33:50] Yeah. So then mid endo you choose to go to perio.

Dooroo Ihm: Yes. [00:33:55]

Payman Langroudi: Um why I think.

Dooroo Ihm: It probably I also had an influence [00:34:00] by the Covid as well. You know, during the Covid, lots of Perrier patients coming in. [00:34:05] Yeah, lots of Perrier is not maintained properly. And [00:34:10] probably speaking of one of my failures was I’ve done [00:34:15] the treatments on Perrier patients and I couldn’t control [00:34:20] the Perrier issues, which if I had known something [00:34:25] more about, you know, more into the Perrier, I could have probably not. [00:34:30] I shouldn’t have done the actual end of treatments because the [00:34:35] foundation isn’t actually looked after before. But when you’re fixed [00:34:40] on the one subject, you tend to see with the narrow visions. [00:34:45] And you know, when when we look at the tooth, okay, whether to save it, to [00:34:50] take it out. So I realised, okay, [00:34:55] I, I’ve learned what I could within the two years because the [00:35:00] third year, usually the distance learning is the dissertation. Yeah. You’re doing [00:35:05] some research article basis. And I thought, why don’t I apply something [00:35:10] on probably will have more passion for the rest of my career which was superior [00:35:15] at Eastman.

Payman Langroudi: Yes.

Dooroo Ihm: So I applied Eastman’s two [00:35:20] years ago and the distance learning again. Yes. Distance learning [00:35:25] again.

Payman Langroudi: It’s three years per year.

Dooroo Ihm: Another three years period. Yes.

Payman Langroudi: And you’re in the middle of that [00:35:30] now?

Dooroo Ihm: Yes. I’m on the last year, third year now.

Payman Langroudi: And the cost of that. Let’s [00:35:35] just let’s just break it down. Is it still 12 or is it more.

Dooroo Ihm: No, it’s way more 20. [00:35:40] I think you could probably halfway. So 15, [00:35:45] 15 a year.

Payman Langroudi: Yeah. And the commitment. What about the commitment, man? That like I said, how [00:35:50] much homework is there? How many lectures are there? Like like how many hours a week.

Dooroo Ihm: It [00:35:55] varies a.

Payman Langroudi: Lot.

Dooroo Ihm: Um, among the university, really, but and [00:36:00] also probably the year of the administration.

Payman Langroudi: I’d expect Eastman’s the [00:36:05] hard core.

Dooroo Ihm: Eastman’s because my, my, my older brother, he’s actually in the kinks. [00:36:10] Yeah. Um, doing distance learning for endodontics. Um, compared [00:36:15] to King’s and Eastman. Eastman is a lot more [00:36:20] focusing. Homeworks? Yeah, yeah, yeah. In a week time, you got to do [00:36:25] this.

Payman Langroudi: It’s famous for it, isn’t it?

Dooroo Ihm: Assignments, like. Yeah. Compared [00:36:30] to my endodontic MSC. That was pretty much leave you alone and [00:36:35] do the lots of cases, and I want you to present it. Oh, no.

Payman Langroudi: Deliverables every [00:36:40] week. Yes.

Dooroo Ihm: But Eastman was more hands on, like, you got [00:36:45] to do this and do that.

Payman Langroudi: So go on, go on. Give me a typical like in a week. How many hours [00:36:50] are you spending on the MSC in a week?

Dooroo Ihm: Probably. You’ll have to sit down decent. Probably [00:36:55] eight eight hours usually on the weekend. [00:37:00] That’s when you’ve got to catch up every day courses and watch the video, because [00:37:05] in a week we get like couple of hours of video. But when you [00:37:10] when you just watch it, you can’t digest it. You’ll have to go back and study [00:37:15] reading articles and study about it. And then some week you got [00:37:20] assignments, which means you can’t go on anywhere. You’ll have to sit there and write articles [00:37:25] and read articles. I’m not particularly the best [00:37:30] student. I’m probably the worst. I mean, I like more clinical, practical [00:37:35] stuff. Yes, to practical is what I like. The thing is, on the reflections [00:37:40] of, you know, writings and reading articles, what I liked about [00:37:45] from Eastman is they also give you what can reflect on [00:37:50] your Practical point. So they have a lot of assignments [00:37:55] saying among your patients when you deliver this treatments, what [00:38:00] you could have done differently, what you could have actually learned from [00:38:05] that case. And these parts are very important for especially someone [00:38:10] who’s doing the distance learning. Yeah. I think because if you don’t actually reflect on your [00:38:15] practical, you can’t learn.

Payman Langroudi: It can become very sort of like book, [00:38:20] can’t it? Exactly. Yeah. So this this is an unfair question. [00:38:25] I don’t know if you said you listened to this pod before. Yeah, but I do ask this question sometimes it’s unfair, but I [00:38:30] just want you to first thing that comes into your head when I say it. What what was your aha moment [00:38:35] with endo and your aha moment with Peria? Like that moment where something [00:38:40] clicked, where you say, oh God, I get it now. What was it? What aspect of those two [00:38:45] when you realised what? Like tell me. Endo. Let’s talk [00:38:50] Endo. Endo. You know [00:38:55] we all studied Endo in uni. Yeah. Yeah. But then you did this extra study and now you said you’re good [00:39:00] at Endo, right? So what was it? What is it about Endo. Which aspect is it? Access. [00:39:05] Is it, is it the cleaning? Is it the filling?

Dooroo Ihm: I think I think.

Payman Langroudi: For me, what moment [00:39:10] was it that made you feel. God, I know I get this now. For me.

Dooroo Ihm: It was the [00:39:15] access cavity. Yeah. Like, a lot of people may spend a lot more time [00:39:20] using different rotary, different systems, you know, system B’s and these [00:39:25] um, and then towards later it became like depending on bioceramic [00:39:30] sealers or none. But for me it was a fundamental access cavity [00:39:35] was the most difficult part I ever faced. But then [00:39:40] towards the end of the my second year of training, the access [00:39:45] was done in a very short time, but clean and nice. [00:39:50] The visibility, the access was brilliant. [00:39:55] And then I think suddenly I start seeing the actual workflow. [00:40:00]

Payman Langroudi: Everything fitted in place after that.

Dooroo Ihm: Because I struggled, because my [00:40:05] access wasn’t good enough to actually finish my treatment. But now, [00:40:10] once I develop the skills that my access is clean and nice and, you know, [00:40:15] perfect. Yeah, but what about it?

Payman Langroudi: I mean, all right, I’ve done loads of access cavities. Yeah, [00:40:20] you’ve done loads of. What is it about your access? Is it bigger?

Dooroo Ihm: Not necessarily bigger, [00:40:25] but it’s just quicker. I think [00:40:30] quicker at the same time. And then with a minimum distractions [00:40:35] as.

Payman Langroudi: In it’s minimally invasive. Yes. So how do you do it? Because you know where [00:40:40] you’re going or do you use ultrasonics or what do you do.

Dooroo Ihm: Well, we use sort of like [00:40:45] ultrasonics at the same time. But then you once you’ve done quite a lot of access [00:40:50] cavity I think there’s, there’s rules to make the access cavity but [00:40:55] you automatically know where you are. Yeah. And I think with that skills [00:41:00] you automatically make not necessarily really narrow access but [00:41:05] the correct correct angles and correct amounts and which then [00:41:10] that will deliver better preparations for the actual canals [00:41:15] because the access is nice.

Payman Langroudi: When you when you do an endo MSC, do they have like a whole [00:41:20] module on access like.

Dooroo Ihm: I think, I think depends on who’s your [00:41:25] teacher? Our teacher head of the department James Pritchard. He [00:41:30] was probably top ten endodontists in the UK [00:41:35] around that time. He focussed on the access cavity, [00:41:40] probably throughout the two years, he [00:41:45] said. If your starting point isn’t good enough, you can’t. You shouldn’t move forward. And [00:41:50] you know how we probably taken a lot of x rays to have a look [00:41:55] where there’s a good and a bad ending? Yeah. Whether it’s failing, he didn’t care too [00:42:00] much about it. He said, take a picture of your axis. Oh, if [00:42:05] you don’t do it, then you can’t improve it. Because it [00:42:10] may appear to be good on x ray sometimes. But then if your axis [00:42:15] isn’t good, it’s not going to work.

Payman Langroudi: It’s so interesting because, you know, the more I’ve had people [00:42:20] sitting here, experts in all all different areas, right? And the [00:42:25] more I learn about it, the more I realise being an expert really [00:42:30] is about doing the basics.

Dooroo Ihm: Fundamental, doing.

Payman Langroudi: The basics very well. [00:42:35] Yeah. Yeah. Not shortcutting the basics. Yes. Yeah. And unfortunately [00:42:40] in dentistry, a lot of what we, we we do. It’s kind of a people looking for hacks. [00:42:45] Yes. People looking for shortcuts. Shortcuts. And that’s [00:42:50] that’s I really think that’s the difference between when you refer someone to a prosecco specialist. [00:42:55] Of course, there’s, you know, treatment planning things and so on. Yeah. But somehow [00:43:00] I want you to say, oh, there’s this magic thing, and you’re not saying there’s a magic thing, you’re just saying, do [00:43:05] it right. Do it. I don’t think.

Dooroo Ihm: There is, actually I don’t think in in [00:43:10] healthcare there is a shortcut. I mean, even when I’m doing the Perrier MSC, like [00:43:15] every teacher is telling us and how to correct [00:43:20] our postures. Mhm. You know, and also the groups of scalers [00:43:25] and how to sharpen them. And it’s just you probably [00:43:30] feel in the first year gosh what am I paying for. Yeah. What am I doing here. [00:43:35] But that’s the fundamental they, they drill into because [00:43:40] with these fundamental things putting together, it will [00:43:45] reflect on the resort and then also it will enhance your speed, quality, [00:43:50] everything.

Payman Langroudi: So let’s talk perio. What’s the aha [00:43:55] in perio that you had?

Dooroo Ihm: I think the perio is when you see the patients [00:44:00] as a review. Yeah that’s.

Payman Langroudi: Satisfying. [00:44:05] Yes. Yeah. But what’s an aha in terms of treatment planning treatment itself? I [00:44:10] don’t know if you’ve gotten to perio plastic surgery and all that. I’ve, I’ve. [00:44:15]

Dooroo Ihm: Actually done like the surgical path now like few [00:44:20] cases I’m doing as I’m in the third year. Um, I’ve seen some [00:44:25] of the really, really good results, like regenerations of the bones [00:44:30] nicely. Um, but I think perio [00:44:35] for me is a still training pathway because [00:44:40] for me Perrier was too many factors [00:44:45] is involved in that field. It’s not like I can deliver good [00:44:50] treatments and then job done. You got the.

Payman Langroudi: Host response and all of that. It’s just it’s a two [00:44:55] multifactorial.

Dooroo Ihm: Yeah. So even for me to say yes, this is the best treatment plan. [00:45:00] This is the best treatment plan. There’s no such a thing. It’s it’s literally [00:45:05] patient journey. You got you got you can help them, but you can’t [00:45:10] change their directions. You can just guide them a little bit. So [00:45:15] for me, it’s probably the most challenging work that I have done so [00:45:20] far because initially you thought it’s going to work. Yeah. [00:45:25] And in the beginning it really, really worked. You know, eight weeks later you [00:45:30] review the patients. Fantastic. Two months later, back to square one. And [00:45:35] then what do you do.

Payman Langroudi: Yeah. I think what people don’t sometimes appreciate is by the [00:45:40] time the patient gets to a periodontist, they’re complex. [00:45:45] Yeah. It’s, you know, in practice you might treat a bunch of perio patients deep [00:45:50] root, plain, whatever it is you do. And and it works out. Yeah. But there [00:45:55] are some patients that with the best oral hygiene, with the best root cleaning. [00:46:00] Still the disease is, is bothering. And it’s a systemic thing. [00:46:05] Yes. Have you looked into that the sort of the link between perio and systemic? You know, what [00:46:10] do they call it? Biological dentistry.

Dooroo Ihm: It’s it’s huge fields to [00:46:15] look into it because it’s it’s something to tell the truth, I [00:46:20] think in private practice is is slightly outside of scope, because [00:46:25] it’s not easy for you to actually communicate with a GP and [00:46:30] to get letters sent out and then have it received. Yeah. And [00:46:35] to maintain those patients, it’s very difficult, I think, for me. Sometimes [00:46:40] I had a lot of, you know, medical compromise patients coming [00:46:45] in for perio treatment. I tell the truth. Go to [00:46:50] go and see one of my teacher in Eastman, because I can treat you [00:46:55] as if short term, but in order to maintain [00:47:00] it for the rest of your life, because the gum disease is chronic disease. [00:47:05] Yeah. And that’s a long, long journey. We’re talking about. So [00:47:10] for me, the systemics involved, if there’s [00:47:15] 1 or 2 that you could control it, it’s fine. But I’m talking about, like, immunocompromised, [00:47:20] like lots of medication. She goes to hospital [00:47:25] in and out quite often. Then I tell them, this is this is [00:47:30] probably beyond what I can help. I think I think that’s, you know, in in all honesty, [00:47:35] I think that’s what we’re also trained to tell the patients.

Payman Langroudi: Yeah. [00:47:40] I mean, you’re right. It’s one of the aspects of being a professional right. [00:47:45] To know your limits. Yes. And if you know someone who can do it better than you, [00:47:50] like what you said about the endo, right? Absolutely. If I’d done two years of endo, I’d be taking [00:47:55] on all the endo myself. But, but but you make a good point, right? If there’s an actual specialist in the [00:48:00] room next door. Yeah.

Dooroo Ihm: I always give it to you because I know, like, [00:48:05] as long as you’ve seen one root canal from him. Yeah. Like, you know, you can [00:48:10] trust. So you pass everything to him, and he appreciates, you know, it worked [00:48:15] together, and then he sends any, any other work to be done for his patient, and he sends it to [00:48:20] me. Yeah. So for me, there’s no like, a lot of people probably think, oh, the [00:48:25] reason why people do study masters is in order to do more [00:48:30] treatments for me. It’s really not for me. It’s not knowing [00:48:35] upsets me. But if I know [00:48:40] it’s okay, not necessarily. I have to be the one of the best in the world. [00:48:45] I don’t like to be. I like to know what what I could offer [00:48:50] to the patients. Yeah, I think that’s the whole reason why I’m doing it.

Payman Langroudi: Which [00:48:55] brings me nicely onto the [00:49:00] reason I’m interested in you.

Dooroo Ihm: I think I know where the conversation [00:49:05] is going.

Payman Langroudi: Yes, well, you’re one of the biggest enlightened users in the country. Mhm. [00:49:10] And it’s funny, man, because like the profile of our users, it’s a very different to [00:49:15] each other. But I want to know you know why, why, why, why is it you do so much bleaching. And [00:49:20] what tips can you give people on that. Because people [00:49:25] suffer with that. You know, I talk to dentists every day who do one a One month, [00:49:30] and then you get someone like you who’s like, every day putting out loads of money. 2 [00:49:35] or 3 a day, like what’s what’s what’s the what’s different about you is, is it that you [00:49:40] doesn’t bother you? This question of I don’t know, people worry that I’m going to embarrass the patient. [00:49:45] People worry that, um, I’m going to look like a pushy salesman. [00:49:50] Like, how come how come those things don’t bother you? And, you know, you’re miles away [00:49:55] from home via Hungary and Hungary and Dublin, and [00:50:00] it’s maybe that’s the reason why it doesn’t bother you, you know, like your outlook is different. Your outlook [00:50:05] is just different to most UK dentists. What do you think?

Dooroo Ihm: Maybe. [00:50:10] But but for me, I mean I was actually surprised [00:50:15] that I do a lot of enlightened.

Payman Langroudi: Firstly, I love that.

Dooroo Ihm: Secondly, [00:50:20] I never actually felt you know, it’s a difficult conversation to [00:50:25] have with patients because. If you listen [00:50:30] very carefully about patients nowadays, they [00:50:35] they also want something in cosmetically [00:50:40] driven treatment. And if you provide [00:50:45] the initial the primary treatment plan and you’ve done it quite [00:50:50] well enough and the patient is also happy what you have also done, then [00:50:55] I tend to give what they want by simply asking, [00:51:00] do you, do you would you like to do any cosmetic work? The [00:51:05] usual conversation is not in a, you know, private practice not everyone’s going to [00:51:10] opt in for I want to do Invisalign, but something [00:51:15] is not too much or not too invasive is whitening [00:51:20] and I don’t bring it up. I guide them to [00:51:25] bring that to me. Then I’ll talk about where we have different.

Payman Langroudi: Do [00:51:30] you really think goes down to this listening?

Dooroo Ihm: I think listening is.

Payman Langroudi: It’s such a big tip, isn’t it? [00:51:35] Listen.

Dooroo Ihm: Listening is probably the key. Like, it’s not like [00:51:40] a lot of people ask me, how do you mention to the patient? But I think they got it wrong [00:51:45] in the first place. It’s not how you bring it up to the patient, how you [00:51:50] listen to the patient. And then let them ask you, because my [00:51:55] patient usually is they ask me, what can I do? [00:52:00]

Payman Langroudi: How do you get it out of them? So okay, patient comes in. It’s an examination lies [00:52:05] back to you straight away. Ask them what’s bothering you and like, how do you get the guy [00:52:10] to to bring it for.

Dooroo Ihm: General Check-up patient? I do all check-ups X-rays [00:52:15] and I mention all the things that they need to have it done. And then [00:52:20] I usually don’t really talk about it straight away on the exam. [00:52:25] I talk about probably towards the end of the treatment [00:52:30] that now we manage to stabilise everything. And [00:52:35] I have seen your compliance. If you want anything cosmetically, [00:52:40] is there anything that you like to have.

Payman Langroudi: Then shut up and listen. [00:52:45] Yeah.

Dooroo Ihm: Then I literally never even mentioned about enlighten any other [00:52:50] whitening Invisalign. Nothing I don’t, I don’t talk and I let them talk. [00:52:55] And then they tend to mention, I think 90% of patients who [00:53:00] doesn’t like to have a little bit brighter teeth. Yeah, everyone does exactly. [00:53:05] But sometimes there they don’t mention it to you because they only met you [00:53:10] for the first time. Yeah. I mean, I think that’s another difficult part. You’ve got to listen to the patient, [00:53:15] like on the first day of meeting someone, they’re not.

Payman Langroudi: Going to open up fully. They’re [00:53:20] not going.

Dooroo Ihm: To open up. And then if you open up too much, putting the shade [00:53:25] next to the, you know, patient’s tooth. They probably might get a little [00:53:30] bit, you know, stepped back and then thinking, oh why? Why? Because I’m not here for this. [00:53:35] Yeah. You know that’s also part of listening. You know, they’re here [00:53:40] to get their teeth clean and then you want to give them what they [00:53:45] want and then you let them decide. I think I think that’s probably [00:53:50] my key. Yeah.

Payman Langroudi: So important like you call that like a EQ? [00:53:55] Like emotional intelligence. Is it? Yeah.

Dooroo Ihm: They were really [00:54:00] thought about it.

Payman Langroudi: Yeah, but it’s like, you know, at the end of the day, it’s chairside manner. Yeah. [00:54:05] What is your chairside manner compared to the next guy? And it’s [00:54:10] we don’t get taught it. You were taught in Hungary, but we don’t get taught it here [00:54:15] very well. There’s a there’s a big bit on the nervous patient which [00:54:20] there should be. Yeah, but, you know, making people feel at ease, listening [00:54:25] to people getting these things out of them is the difference between a good [00:54:30] dentist and a great dentist. You know, I’ve treated.

Dooroo Ihm: One of my patients last [00:54:35] week. Um, she hadn’t been to the dentist for six [00:54:40] and a half years. She came in for a consultation to me, and I spent half [00:54:45] an hour just talking and listening. And she [00:54:50] got all the treatments done and finished last week. And her husband came [00:54:55] in and she he said to me, I dragged her to 20 [00:55:00] different practices in London and she never wanted [00:55:05] to go back. But on the day you spend half an hour just [00:55:10] talking, not.

Payman Langroudi: Doing any treatment.

Dooroo Ihm: Not doing any treatment she wants. She paid [00:55:15] a deposit for the full treatments. How did you do that? [00:55:20] And then I. I asked her back, why did you come back to [00:55:25] me? She said to me, because you listened to me. And I think, I think that’s probably [00:55:30] the key message, that if I can help any other practice [00:55:35] or clinicians, that I would importantly message to them saying, [00:55:40] certainly. Listen. Yeah.

Payman Langroudi: Love that. Let’s get on to the darker parts [00:55:45] of this pod. Yes. I don’t know why I love it so much, but [00:55:50] I want to talk about clinical errors. Yes. Black box [00:55:55] thinking. Have you. Have you heard about black box thinking? It’s a plane crash. Plane [00:56:00] crash? Yeah. They go look at the black box. Yeah. And then when they find [00:56:05] out what happened, they share with the whole pilot community [00:56:10] what happened. And blame isn’t part of it at all. Yeah. They just [00:56:15] want people to learn so that that thing doesn’t happen again. But in medical, we [00:56:20] don’t tend to do that because blame is really huge in medical. For [00:56:25] some reason. Yeah. And so what happens is we tend to hide our errors. And then what happens [00:56:30] is the whole community doesn’t learn from the mistakes. So in order to [00:56:35] fix that little problem. Mhm. I want to hear about mistakes. What what [00:56:40] comes to mind when when I say what are some mistakes or the biggest [00:56:45] mistake you’ve made. I think I mean what did you learn.

Dooroo Ihm: Too many mistakes. [00:56:50] I mean to even pinpoint even one like. Extractions. [00:56:55] Root canals. Perio. [00:57:00]

Payman Langroudi: Yeah. What kind of mistakes. Like I think.

Dooroo Ihm: Because the endodontic [00:57:05] treatments that, you know, when I was doing the masters, I took on some [00:57:10] difficult case that I should have, you [00:57:15] know, really look into whether it might be fractured tooth or not. Carried [00:57:20] on, missed a fracture. Yeah. Mr.. Fracture carried on, and [00:57:25] I probably could have seen with the loops [00:57:30] that there is a minor fracture line, but probably I tend like I [00:57:35] decided, probably ignore it because.

Payman Langroudi: Subconsciously sort of.

Dooroo Ihm: And then [00:57:40] by the time when I finished the treatments and then fill [00:57:45] the call back up nicely and then twist open, [00:57:50] you know, straight away.

Payman Langroudi: Wow.

Dooroo Ihm: And [00:57:55] I learned from that mistake quite a lot, because [00:58:00] one, I wasted that entire clinical time [00:58:05] and the tooth came like completely fractured. So I had to [00:58:10] take that tooth out and I didn’t know what to say to the patient. So [00:58:15] luckily it was an easygoing patient. So I explained the situation and nicely [00:58:20] got it done. But that’s another mistakes.

Payman Langroudi: And so now [00:58:25] when you when you’re doing endo you’re looking extra hard for fractures. Exactly. It’s [00:58:30] so interesting isn’t it. Like that little experience for you.

Dooroo Ihm: Occlusions and [00:58:35] why it could have an impact on my treatments. Yeah. And [00:58:40] you know, the other case that I mentioned that I’ve done an endo treatment on [00:58:45] ongoing perio patients. Yeah, yeah. So we do have [00:58:50] to know the endo period lesions. Yeah. Which is involved in two disease together [00:58:55] which I didn’t I purely focus on endodontic [00:59:00] treatments. So that’s me neglecting about the the foundations [00:59:05] period. Um, that’s another failure that I had. Massive failure. It [00:59:10] was didn’t heal at all because.

Payman Langroudi: So you spent hours getting this NDA, right? But [00:59:15] the it was getting reinfected by the period.

Dooroo Ihm: Absolutely. Because I think when [00:59:20] you’re looking at end of period lesion, obviously you’ve got to treat them both. You can’t just treat one and [00:59:25] hoping it’s going to heal automatically. So it was it was never going to work. [00:59:30] And that’s probably another mistake that I learn from as well.

Payman Langroudi: How [00:59:35] about one where how did the patient react to that.

Dooroo Ihm: Wasn’t [00:59:40] happy at all.

Payman Langroudi: It wasn’t.

Dooroo Ihm: Happy. No, I had to I had to give the full money back. [00:59:45] Really? Yeah. But then I that was my mistakes. That I [00:59:50] didn’t really see through all the other treatments. And I think that that through [00:59:55] out that mistake. What I learned a lot from it is what [01:00:00] I talked about is comprehensive.

Payman Langroudi: Comprehensive treatment planning.

Dooroo Ihm: Because if [01:00:05] you if you look into another mistake that I made, it’s Is probably [01:00:10] something a lot of people don’t probably think this is a mistake. I’ve [01:00:15] seen a 16 year old child had a huge [01:00:20] cavity on upper lip syncs, like through the pulp chamber. I’ve [01:00:25] given a root canal treatment plan and. Restore [01:00:30] ability wasn’t so great. [01:00:35] And then I intend to do, you know, a pacifications [01:00:40] to enhance the root closures. And my mentor [01:00:45] came along and he goes, are you delusional? What in the name [01:00:50] of God are you are you going to do with this child? And I looked at him like, [01:00:55] what have I done wrong? Like, I genuinely because I’ve started a root [01:01:00] canal treatment. And he looked at the amount of, you know, [01:01:05] destruction left. And he was This is a cowboy [01:01:10] dentist. What are you doing? And he said to me, if [01:01:15] you just extract that tooth, I’m going to shift to seven and eight and [01:01:20] put in that positions. It’s fine because [01:01:25] he needs ortho and that’s another.

Payman Langroudi: There you go. Comprehensive [01:01:30] treatment.

Dooroo Ihm: Plan. That’s something I didn’t think about. And he he looked at me like obviously he didn’t say it [01:01:35] in front of the patient. He called me out saying, dude, I know you’re passionate about [01:01:40] and you’re studying about endo, but realistically speaking, do you think your endo [01:01:45] and The Crown really like heavily restored crown? Would [01:01:50] it last in his mouth more than 60 years because he’s 16? [01:01:55] What do you think? And I didn’t think about that.

Payman Langroudi: Yeah. [01:02:00]

Dooroo Ihm: And that’s when I learned, gosh, I could have saved a lot [01:02:05] of money for that child, and that money could have gone towards the author. Yeah. [01:02:10] And then he could have had a nicer such a beautiful smile. At the same time. He [01:02:15] had a perfect molar bite.

Payman Langroudi: Were you aware that author was going [01:02:20] to happen?

Dooroo Ihm: I knew, but I it didn’t.

Payman Langroudi: You didn’t [01:02:25] connect the dots?

Dooroo Ihm: Yeah. No.

Payman Langroudi: Yeah.

Dooroo Ihm: And obviously that that requires [01:02:30] some team members in, in practice that to be able to, you know, work together [01:02:35] multidisciplinary.

Payman Langroudi: Um, I mean, it’s it’s a good point that the sixes [01:02:40] it depends like here there’s quite a lot of decay, [01:02:45] you know, and so knowing that sixes are [01:02:50] not going to last when they’ve had fillings when they’re 13 year old and then filling again [01:02:55] at 16. And you know, sometimes it’s a good point. It’s a good point what you’re [01:03:00] saying there. How about a case where the patient really didn’t take it well at all. [01:03:05] Like, well, who’s your most difficult patient? What comes to mind? [01:03:10]

Dooroo Ihm: Difficult patient is probably early loss [01:03:15] with the dentures. And they expect [01:03:20] something more likely to be. Have it done.

Payman Langroudi: Yeah. They don’t see it as a wooden leg. Right. [01:03:25] Exactly. Yeah. Yeah.

Dooroo Ihm: I think these patients are difficult. And also. [01:03:30]

Payman Langroudi: But could you think of one?

Dooroo Ihm: I [01:03:35] had a patient that lost probably all [01:03:40] of his teeth, apart from two teeth hanging in due [01:03:45] to the Perrier. He asked me to have [01:03:50] a nice set of implants or on six [01:03:55] or on four. And he’s seen another consultation and they said, no, we can’t [01:04:00] do this is nearly impossible. And then he came back to me saying, [01:04:05] I want nice denture that doesn’t move at all. And [01:04:10] I simply described to him, it’s not possible, but [01:04:15] I need some retentions, otherwise I can’t. Um, [01:04:20] because it’s pretty flat. There’s not structures that I can use [01:04:25] or hold onto because he’s lost his teeth probably 30 years ago. Yeah. And [01:04:30] he’s been using nothing. He’s been grinding with their [01:04:35] alveolar process together. And I think I made it I [01:04:40] made it probably what I could do the best denture you [01:04:45] could. And he wasn’t happy.

Payman Langroudi: Yeah. That can get really psychologically [01:04:50] damaging. Yeah.

Dooroo Ihm: And then I’m thinking maybe in, you [01:04:55] know, in a sense that, you know, you you’re thinking maybe you shouldn’t have treated him. Yeah. Yeah, [01:05:00] yeah. But then on the other hand, he wasn’t happy. But [01:05:05] I could see him every, every time that he’s using the denture. So [01:05:10] at least I got to at some point. But [01:05:15] I couldn’t really make him happy. You know, I think that’s that’s difficult [01:05:20] patience for me.

Payman Langroudi: I think it gets particularly difficult if you’re like, that’s [01:05:25] a difficult situation. Yeah. You’re trying your best. You’re really trying your best. [01:05:30] You’re asking people you’re doing everything correctly. And [01:05:35] then a complaint comes in and the patient says something like, you weren’t [01:05:40] trying. You, you know, you you did a bad job. And it’s weird because [01:05:45] often the patients you go out of your way for are the ones that end up that way. And, [01:05:50] you know, the thing is, you’re going out of your way to do something slightly out of the ordinary, which [01:05:55] is get this guy retention where retention isn’t possible, you know, And then [01:06:00] that becomes the patient that complains. I think as you get older, your sixth sense kind of kicks [01:06:05] in and you learn to avoid those patients. But again, [01:06:10] for for younger dentists, it’s part of the process. It’s part of the learning process. [01:06:15]

Dooroo Ihm: The learning process is really because my dad’s always giving [01:06:20] me advice because I thought it was a case. Selection is important. What [01:06:25] case you can do what you can’t do. Yeah, which is important as well. But then my [01:06:30] dad and my uncle said to me, once you get to the certain years of experience, what you tend to do [01:06:35] is not selecting by the case, you select by the patients, and then that’s [01:06:40] something you will learn, not necessarily your, you know, ignoring some [01:06:45] of the patient, but to be able to provide those kind of treatment plans that [01:06:50] you would select those patient to do because, you know, at the end of the day, [01:06:55] they’re not going to be the one causing a problem. Yeah. We come back.

Payman Langroudi: To that relationship [01:07:00] with your patient. Right. Mhm. What would you do if you had half [01:07:05] a day off from everything and everyone. No [01:07:10] expectations. No homework. What. [01:07:15] Go for a drive. A drive. Yeah. What kind of. What kind of a drive.

Dooroo Ihm: Just [01:07:20] countryside. Yeah. The place I like to [01:07:25] go when I want to switch off. Everything is either Cotswold or Lake [01:07:30] District. Oh, really? Somewhere. Somewhere. Really? Countryside. You know, not [01:07:35] many people. Peaceful within the nature. Switch off [01:07:40] everything. Yeah. I’ve got. I’ve got two dogs, so. Oh, really? And I usually take them out [01:07:45] for a walk and, you know, sit there and just. Yeah. Spending time [01:07:50] in the nature. Yeah. I think that that’s that gives me the peaceful [01:07:55] Minds and to just, you know, get rid of all the stress [01:08:00] that you had.

Payman Langroudi: Recharge.

Dooroo Ihm: Yeah, absolutely.

Payman Langroudi: Amazing. [01:08:05] Let’s end it with our usual questions. I’ve enjoyed this fantasy dinner [01:08:10] party. Three guests, dead or alive. Who would [01:08:15] you have?

Dooroo Ihm: I think first guess is my parents, obviously.

Payman Langroudi: Um, [01:08:20] should we have them as one guest? Yeah. Yeah, I think I think.

Dooroo Ihm: My parents, just for [01:08:25] me, extraordinarily, I spend a lot of time talking to my dad [01:08:30] because we share the same path and passions about dentistry. And [01:08:35] my mom actually went to hygienist cause she. She used to be a math [01:08:40] teacher. Um, she retired in early age [01:08:45] because my dad didn’t want her to work. And my dad wanted her to look after me and [01:08:50] my brother when I went to dental school, I hated it, I [01:08:55] hate studying.

Payman Langroudi: God, but you’re a maths teacher in [01:09:00] Korea, mum. Oh my God, you must have had that Kumon stuff [01:09:05] going. Yeah. Oh my goodness. My heart sinks when you say. [01:09:10] Mum, who’s a math teacher in Korea? Go on. Um. [01:09:15]

Dooroo Ihm: And then she went [01:09:20] to the Hygienic Schools. To show me at even her age, 60, [01:09:25] I can still study.

Payman Langroudi: Oh, at that point. Wow. So what a woman, I [01:09:30] like that.

Dooroo Ihm: No, she actually works in dad’s clinics. You know. Oh, really? As [01:09:35] a hygienist. Here and there. And I think that’s why they encouraged [01:09:40] me a lot. And they actually support me. Throughout their life. If [01:09:45] I, if I think about now, you know, I’m at the age of talking about having a kids [01:09:50] or not. I don’t think I can ever sacrifice that much [01:09:55] like what they have done for me. So they’re probably the first in the guest. [01:10:00] Second guest would be Sean Murray, the practice [01:10:05] owner where I worked in Dublin. Excellent, because for me, he’s still [01:10:10] one of the best dentists that I look upon. Because on [01:10:15] Saturday, I remember one day as an emergency [01:10:20] patient came in, didn’t have any money. He didn’t have any [01:10:25] money whatsoever. He was in excruciating pain. Sean [01:10:30] happened to come in on Saturday, just do some paperwork. I was working on that [01:10:35] day and he just took the patient in by himself, and then he got [01:10:40] all the treatment done, and he let him go without paying anything. And [01:10:45] I simply went up to him after work and asked him, why did you do that? And [01:10:50] he said to me, because I can’t. Yeah that’s true. [01:10:55] Before thinking about how much money you make, how [01:11:00] much we can actually deliver, you’ve got to put patient first. Well, [01:11:05] whether they’re going to come back or they’re going to come come back with money or not, [01:11:10] you’ve got to treat them. And I don’t work on Saturday, but I happen to be here. [01:11:15] Just a coincidence. I’ve got to help them. And I think from that moment [01:11:20] I thought, I want to be like him. You know, I want to be a [01:11:25] genuinely a good dentist. Doesn’t have to be, you know, my name needs to be top [01:11:30] of the, you know, list. I just want to be a good dentist, I think. I think that’s [01:11:35] why it’s probably the second in the guest. Third [01:11:40] Gordon Ramsay.

Payman Langroudi: Why? Gordon Ramsay like [01:11:45] watching him.

Dooroo Ihm: I think I got through [01:11:50] my dental school because of him. What? Um. When I was studying in dental [01:11:55] school, I hated studying, so I started watching his cooking show. [01:12:00] Yeah. And you know how he expresses anger? [01:12:05] Yeah. I loved it.

Payman Langroudi: Yeah, I loved it. I love it. I love it on TikTok. I love it on TikTok. I love it [01:12:10] when he’s screaming at someone. And then you donkey.

Dooroo Ihm: I actually [01:12:15] start, you know, cooking as a as a hobby.

Payman Langroudi: Yeah. [01:12:20] And because of it. Yeah.

Dooroo Ihm: Because of it. And it actually took my mind off quite [01:12:25] a lot of times. So. Yeah.

Payman Langroudi: That’s a nice little party, [01:12:30] man. He could do the cooking, right? Absolutely. Some. [01:12:35] Some people. Yeah. Yeah. Some people invite, I don’t know, Michael Jackson to do the singing. You’ve [01:12:40] shortcutted the cooking. Final question. The [01:12:45] deathbed question. A bit weird for someone as young as you, but you’re [01:12:50] on your deathbed, surrounded by your friends, family, loved ones. You [01:12:55] can give them three pieces of wisdom. What would they be?

Dooroo Ihm: I [01:13:00] think one is never give up. If you if you want something, [01:13:05] you’ve got to put everything what you have to achieve. Secondly, [01:13:10] listening to others very [01:13:15] similar to the what I like to do with my patient. Listen to [01:13:20] others. You don’t have to talk too much, just listen to others. Thirdly, [01:13:25] dream big. I think you’ve got to dream big. If [01:13:30] you if you if you want something, you’ve got to. Because I think if [01:13:35] you if you want to set the goals, you know, really, really big, [01:13:40] you’re bound to get somewhere close by Because [01:13:45] we’re not perfect. We’re human being. Yeah, we tend to fail. Not [01:13:50] everyone will make it through, you know. But if you dream big enough, I think [01:13:55] you will always get there.

Payman Langroudi: It’s good advice. It’s good advice. Do you think you’ll go back [01:14:00] to Korea eventually?

Dooroo Ihm: Thoughtful for [01:14:05] the time being? No, I don’t think so.

Payman Langroudi: But eventually.

Dooroo Ihm: Even though I don’t think so. [01:14:10]

Payman Langroudi: Really?

Dooroo Ihm: Yeah. Because you know how probably a lot of Asians [01:14:15] or immigrants probably feel about living abroad. [01:14:20] Yeah. But for me, I’m used to it. I’ve done it from age [01:14:25] 16 on my own. And compared to that time, it’s [01:14:30] nothing. And I like the country and. Yeah.

Payman Langroudi: And [01:14:35] your partner’s Korean, you said. Yes. She is. Don’t you think it’s hard, [01:14:40] for instance, having kids without your parents around? I mean, I did it, by the way. I [01:14:45] had kids, my parents and my wife’s parents were abroad. Tough. [01:14:50] It is tough.

Dooroo Ihm: I think that’s probably another reason why I’m actually in the process [01:14:55] of talking to my parents to come home. Yeah. Convince them to move here. Yeah.

Payman Langroudi: And by the way, one [01:15:00] of the most loveliest thing about having kids is the relationship with your parents, with, you know, with their grandparents. [01:15:05] Yes. Probably the loveliest thing about having children. If you’re if [01:15:10] you’re thinking about children, it’s the best thing about having children. That relationship, watching that relationship, [01:15:15] you know? Okay.

Dooroo Ihm: Um, when did you have your first.

Payman Langroudi: Mine are 17 [01:15:20] and 14 now. Okay. And since since that time, my parents have moved [01:15:25] back to. Okay. Okay. Um, but, you know, having kids is hard. Hard. [01:15:30] And so you want the plus side as much as you can. Right? As [01:15:35] much as I can. Yeah.

Dooroo Ihm: That will that will help.

Payman Langroudi: Massive pleasure to have you. Thank [01:15:40] you so much for coming in. Thank you very.

[TRANSITION]: Much.

Payman Langroudi: Really, really enjoyed that. I actually learnt a lot from you. I mean.

Dooroo Ihm: I’ve [01:15:45] learned a lot from using enlightened company and [01:15:50] it’s just an amazing journey.

Payman Langroudi: I just learned a lot from you on this conversation. I really, really did. [01:15:55] Thank you so much. Thank you.

[VOICE]: This is Dental Leaders, [01:16:00] the podcast where you get to go one on one with emerging leaders [01:16:05] in dentistry. Your hosts Payman [01:16:10] Langroudi and Prav Solanki.

Prav Solanki: Thanks for listening guys. [01:16:15] If you got this far, you must have listened to the whole thing. And just a huge thank you both from [01:16:20] me and pay for actually sticking through and listening to what we had to say and what our guest has [01:16:25] had to say, because I’m assuming you got some value out of it.

Payman Langroudi: If you did get some value out of it, think [01:16:30] about subscribing. And if you would share this with a friend who you think [01:16:35] might get some value out of it too. Thank you so, so, so much for listening. Thanks.

Prav Solanki: And don’t forget our six [01:16:40] star rating.

Steffen Decker: And now comes the power of an orthodontist. Again, how about combining [00:00:05] techniques? Why not choose the best of each world? [00:00:10] Why not align the upper with the aligner? No speech impact? Nothing. No. [00:00:15] Very discreet. And the lower curve of spee. You do a lingual for [00:00:20] four months.

Payman Langroudi: How interesting.

Steffen Decker: Take it out. Finish with an aligner. [00:00:25] We call this hybrid approach. Why do you not use your strength and orthodontic specialists [00:00:30] to combine techniques? Why do you need to do everything with lines?

[VOICE]: This [00:00:35] is Dental [00:00:40] Leaders, the podcast where you get to go one [00:00:45] on one with emerging leaders in dentistry. Your [00:00:50] hosts Payman Langroudi and Prav Solanki. [00:00:55]

Payman Langroudi: It gives me great pleasure to welcome Stefan Decker onto the podcast. [00:01:00] Stefan is an old friend. I must have met you 15 years ago. [00:01:05] Along the way. Along the way. So that was one of one of the world’s top orthodontists [00:01:10] involved in all sorts of different things. So, uh, originally [00:01:15] I remember you doing a lot of lingual orthodontics on adults. One [00:01:20] of the world’s top providers of incognito. At one point, were you? Yeah. Um, now [00:01:25] focusing more in on kids with aligners and Interceptive orthodontics. [00:01:30] Um, Steven, it’s a pleasure to have you. You. I read on your CV you were also [00:01:35] a choice accredited orthodontist, which really piqued my interest. And [00:01:40] we tend to start with sort of backstory, but I’ve got a burning question about [00:01:45] the choice thing, the sort of the link between the orthodontist [00:01:50] and the prosthodontist. Did it open your eyes to go to the [00:01:55] choice?

Steffen Decker: You know what? Like it’s As probably a lot of people know, I’m married to probably one [00:02:00] of the top restorative dentists in the country who is a college trained dentist. Como. Como. And, [00:02:05] um, when I started working for her, the first question she [00:02:10] asked me was, Stefan, have you ever seen your cases failing? 30 [00:02:15] years after you finished them? And I was thinking at that time, don’t [00:02:20] forget, I was number one incognito provider in the world with adults. [00:02:25] So I thought, hold on. Who are you attacking me? Are you telling me I can’t do my profession? [00:02:30] What do you mean? So she showed me adult cases with rare facets. [00:02:35] Traumatic bites, destruction on the dentition caused by a [00:02:40] poor functional bite. At the end of orthodontics, a few years before that. [00:02:45]

Payman Langroudi: A constricted.

Steffen Decker: Constricted envelope of function. And if the restorative work basically [00:02:50] failed. So she said to me, Stefan, in order for you to work for me, pre [00:02:55] restoratively you will need to see John Kois and I had no idea [00:03:00] at this point who John Kois is because I’m an orthodontist. I live in my own bubble. So I [00:03:05] went to Seattle, I did the courses and I remember really well. I won the one [00:03:10] afternoon I called Komal back and said to her, I get you. I understand [00:03:15] why you speak with your patients the way you do it. What wording you use, [00:03:20] because that’s John. John says exactly that. It opened my [00:03:25] eyes to understand how to dentists think when they want to restore [00:03:30] an adult case. Because what is my work good at? If [00:03:35] it’s not good enough for restorative dentists to fail? And this [00:03:40] change for me, everything because I had a completely different understanding of the wording, [00:03:45] the word you use in the restorative world. And it helped me now even more [00:03:50] so to work with restorative dentists so that I could do my alignment job in [00:03:55] a good way, and I didn’t need their input for me to tell me where to move the teeth for [00:04:00] them to restore. I could just hand it Sandra Garcia.

Steffen Decker: At that point in Harley Street, the case is over. And [00:04:05] she did the veneers. Easy. It was a very lovely relationship, work, relationship. But [00:04:10] if you look at what’s happening nowadays, dentists tend to do [00:04:15] everything themselves. They do the alignment with clear aligner, then they do the bleaching [00:04:20] and the bonding. But if they would have had a good orthodontist [00:04:25] who would know how to position teeth correctly, they wouldn’t have the [00:04:30] need to do the alignment. They could just focus on what they would like to do, which [00:04:35] is the restorative side of things, because I worked in enough places to make that become [00:04:40] aware that, financially speaking, there they are lowering the price [00:04:45] of the alignment so hard that they don’t make a lot of profit on the alignment. [00:04:50] They make the profit on the restorative. So for them, it’s not even a big business. [00:04:55] The alignment. It is something they want to do good restorative work. So if they [00:05:00] would give that to a good orthodontist who has the knowledge from John in Seattle, that [00:05:05] would help them to have more business themselves, but unfortunately that’s not happening. [00:05:10] The orthodontists live in their own bubble, the restorative dentists in their other bubble, and [00:05:15] more and more restorative dentists knowing how to use aligners.

Steffen Decker: So the market [00:05:20] becomes very limited for me as an orthodontist to be different. And at [00:05:25] the time you were talking about with lingual, that made me different. I choose to choose use [00:05:30] a device that was different, and not everyone could do lingual braces. That [00:05:35] made me different. But now everyone wants aligners. What makes me different now? Maybe [00:05:40] I focus on an age group nobody is catering for, which is [00:05:45] children. And then when you do that and my fundamental training is children, [00:05:50] I was trained in Germany and Switzerland. When I was in these countries, I treated children, [00:05:55] no adults. But when I moved to London, I was forced to treat adults because [00:06:00] I was in the middle of London. So my training was kids. And by me, having this new [00:06:05] technology of clear lines in my hands made me realise it comes with benefits [00:06:10] with kids. Because compared to what we used to do with screws and [00:06:15] acrylic devices, bulky devices where kids tend to not wear it long [00:06:20] enough to have an impact with the liners. They love it. It’s comfortable. [00:06:25] They can decorate it with stickers. Biomechanically speaking. It’s really predictable [00:06:30] in kids, so that made me.

Payman Langroudi: Moves quicker.

Steffen Decker: Because the research is very [00:06:35] clear that expanding an arch and opening spaces with the liners is [00:06:40] super predictable versus root movement, not so predictable extraction disaster. [00:06:45] So. But with kids in in early interceptive. Treatment. All you have to [00:06:50] do is create space, widen the arches, create a good foundation [00:06:55] bone foundation in order for the teeth to fit in. This is your task, so [00:07:00] an aligner is really good in it. And guess what? They love it because their [00:07:05] parents might have an align already. The kid says I want this as well. I want to be cool as well, like [00:07:10] my mommy and my daddy. So it’s in fashion. And that is really to the benefit of me [00:07:15] now because the kids demand it. They go to the mom, I want this now. And my friend is [00:07:20] saving now. The community where I live in is growing. And because orthodontics [00:07:25] seems to focus on tooth alignment and it doesn’t focus [00:07:30] so much on what does the creating space do with tongue [00:07:35] positioning, what does it do to more airway available for a child [00:07:40] to breathe properly? What does that do to their sleep quality to their [00:07:45] behaviour? So unless as a side effect of doing good prevention, creating [00:07:50] bigger foundations, we have a lot of health benefits for a child. And this [00:07:55] is where I get now emotional because you actually help them not [00:08:00] only in their appearance and to fit teeth in, you also help them to have [00:08:05] a better, healthier life. And the more you do that you get, [00:08:10] then suddenly cases in who come to you because their child is getting [00:08:15] bullied at school because their child had a trauma in rugby, because their child is [00:08:20] suffering with breathing or speech, and then you help them.

Steffen Decker: And that is the most [00:08:25] rewarding part of your profession. Why you did that in the first place when you started [00:08:30] is you, you, you said, I want to help children. Now. [00:08:35] I do exactly that every day, which means I have job satisfaction. [00:08:40] And five, six years ago when the market went crazy [00:08:45] with the liners. My fees were too high with lingo. Everyone used to go [00:08:50] to a dentist because the price package was lower. So I was frustrated because all [00:08:55] that was left for me as an orthodontist was surgery cases. All [00:09:00] the easy alignment cases was done by dentists. So I said, why did I study [00:09:05] for years and years to only treat adults who need eventually jaw surgery [00:09:10] or very complex alignment? And don’t forget adults. They come with a [00:09:15] backpack of emotions of other things that impact them in their life. So [00:09:20] you don’t just have to do your job, you might as well be a psychologist on the side as [00:09:25] well. With kids, they want you. They want your help. [00:09:30] They want to look better. They want to breathe better. They want to speak better. If you do this job, [00:09:35] they love you. They might just say to you, thank you or give you a hug. [00:09:40] But sometimes they really write you a nice note. And that is something for me as an orthodontist [00:09:45] is the most rewarding thing I can perceive. So I love my job again [00:09:50] versus six years ago I was at the time in my life, I said, why am I doing [00:09:55] this? Why do I fight for it so hard to get eventually disrespect [00:10:00] from an adult or at the end of a line? They say to me, now you know what? This and [00:10:05] this is not perfect.

Payman Langroudi: Incredibly picky at the end right here.

Steffen Decker: Because they want bonding, they want whitening, [00:10:10] they want the perfect world, which is shown to them every day on social media in [00:10:15] a kit. They don’t want that. They’re getting bullied at school. They’re embarrassed to [00:10:20] socialise. They want you to improve their smile. That is it. They’re [00:10:25] not picky at all. And if you do that and you do that in a child, the parents [00:10:30] comes back to you and says to me, thank you for changing the life of [00:10:35] my kid. Can you see me as well? Would be a huge honour if I see [00:10:40] them very different. So my market has completely changed from focusing [00:10:45] on kids. They bring their siblings and hence their parents. [00:10:50] So I don’t need to do marketing on adults anymore because they’re coming through the door anyway. My [00:10:55] wife, Komal, we have a practice together. She does need to do marketing on adults because the parents [00:11:00] are coming with the kids and then they eventually ask, do you offer dentistry for us as [00:11:05] well? And we can then choose to say yes or no. If [00:11:10] we like the parent, we can say yes. My wife will help you if we don’t like them [00:11:15] because of whatever reason it is, we can say no. We focus on children, so it makes [00:11:20] my life much more lovable, liveable and our atmosphere [00:11:25] in the clinic changed because we have smiles.

Steffen Decker: Yes, we all talk about creating [00:11:30] smiles, but it’s a feeling that comes with it. And my girls, the most important thing for my girls [00:11:35] that they’re happy smile because that’s what we’re doing every day. So my life [00:11:40] changed again, and now, most likely I will never change back to anything else. Because [00:11:45] what I’ve seen is the demand for doing early Interceptive [00:11:50] orthodontics is so huge, especially here in the UK, where the [00:11:55] NHS funding tends to be for teenagers. Even so, there [00:12:00] would be funding Interceptive orthodontics by the guideline, but it doesn’t give them enough [00:12:05] remuneration. Hence orthodontists tend to do teenagers, but [00:12:10] they forget that the kids are not happy, they’re suffering. [00:12:15] And if you understand that that the need is there, maybe you would dedicate [00:12:20] yourself more time in kids and have more job satisfaction. That’s my personal opinion [00:12:25] in that because it changed my life and I’m really happy with what I do now [00:12:30] and with the teachings, I think, to create more awareness. That’s why I’m here today as well, because [00:12:35] I would love more dentist, paediatric dentist or orthodontist to understand. [00:12:40] We should do kids. It’s much nicer when you say kids.

Payman Langroudi: Do you mean pre 11 year old [00:12:45] kids pre 11?

Steffen Decker: Because especially when it comes to lines that the companies will make [00:12:50] you believe the big market for aligners is teenagers. But [00:12:55] when you treat a lot of teenagers with aligners, you understand eventually [00:13:00] they drop out. They have a girlfriend, they have other things in their life to do. They forget there [00:13:05] is no incentive for them anymore to do more because the teeth look good. [00:13:10] Are they perfect? Maybe not. Why would I wear an aligner if my teeth are straight? Why [00:13:15] would I wear elastics if my teeth are straight? So the perception changes versus [00:13:20] a young child. If your little princess has a problem and you will say [00:13:25] to her, look, you should do that, otherwise we might have to extract teeth later on in life, every [00:13:30] girl and every boy will say, no, I don’t want that. I’m going to do it. Daddy tells [00:13:35] me to do it. I will do it because we are more in charge. I have three children myself. They are all finished with [00:13:40] orthodontics. They are now 11 and nine. They are finished.

Payman Langroudi: Is that the key? [00:13:45] I mean, I understand the social benefits that you alluded to, but the clinical [00:13:50] benefit is the key clinical benefit that you don’t need to do extraction well later in life. They had a.

Steffen Decker: Lot of [00:13:55] benefits to that. Number one, coming back to John Kois, we [00:14:00] learn when we talk in John, we look at adult cases of where of destruction, [00:14:05] and we talk about how to deprogram the buy to get care position [00:14:10] and then how to restore that case in order to be stable long term. [00:14:15] But the I went to John and I said to him, John, what [00:14:20] would have happened to that adult if we would have a better foundation, if [00:14:25] we would have widened the arch, if you would have done good orthodontics as a child, would [00:14:30] that have still happened? And he said to me, Maybe not. This [00:14:35] was the day I went back to my children to look for function and occlusion [00:14:40] problems. And I see where on five for six [00:14:45] seven year old kids with deep bites, very minimal, maybe half a millimetre, [00:14:50] one millimetre. But with technology scanner, you can see it. You can you can measure [00:14:55] it physically. Every year the destruction happened. So it came clear to me, oh my [00:15:00] goodness, when does this start? This problem with function constriction [00:15:05] envelope of function. Because what we tend to do is one tooth dentistry. We have a tooth [00:15:10] failing. Put a crown on it. We don’t look at the overall. Where does it [00:15:15] start? Where did it start. And I can go in both directions. [00:15:20] Now I can say to a child, if you don’t address your bite right now, you [00:15:25] might have where in ten, 20, 30 years time you might end up in extractions. [00:15:30] You might end up in TMJ pain if it happens. And guess what the pans tell me. [00:15:35]

Steffen Decker: Excuse me. I’m happy that all. I had four teeth taken out. I [00:15:40] have TMJ pain, I have a lot of restorative work and my teeth are perfectly fine. I [00:15:45] don’t eat sugar. I don’t do anything. I still have root canal. Why? Because the teeth cracked, [00:15:50] the bacteria went in and the root canal. So when you talk to kids like this and [00:15:55] explain them what could happen, it opens the mindset of the parent and say, [00:16:00] hold on a minute. He just told my story, which happened to me all [00:16:05] the way because my parents didn’t know any different that we can do it early. So I had the extractions [00:16:10] and before you had someone talking about mouth breathing, sleep apnoea, [00:16:15] in order for a tongue to have to rest on the palate, [00:16:20] we need space in the palate. If there’s no space, how can the tongue [00:16:25] rest there? What is happening with this tongue? At night when we are at rest, it will [00:16:30] fall into your airway. We open our mouth. We adopting a mouth breathing habit which [00:16:35] is not good for our sleep quality. So we might struggle, we might snore. We [00:16:40] might have sleeping disordered breathing. So that is where it can be. The link. [00:16:45] What happens to your child if it’s very disrupted? Sleep. It’s heavy, active [00:16:50] all night because it needs to wake up to get oxygen. How do you think that child will concentrate [00:16:55] at school? How do you think your child will behave if it’s consistently [00:17:00] being reminded by the nervous system? Wake up, get oxygen, get oxygen. So [00:17:05] there might be a link to this.

Steffen Decker: Yes, research is very [00:17:10] vague on that. And you can say now there’s not enough evidence. And the [00:17:15] new research says yes, there’s not a lot of evidence. But not having evidence right [00:17:20] now doesn’t mean there’s no evidence, because if you speak to parents, you speak to [00:17:25] adults, it always comes back to the same pattern. And very interesting [00:17:30] thing. Just lately Apple launched a new watch. Now Apple Watch ten [00:17:35] detecting sleep apnoea. So that means very [00:17:40] soon our kids, our parents will have variables on their wrist saying [00:17:45] to them, morning, your sleep changed. You stopped breathing. So [00:17:50] what could happen now if they had an intervention, whatever intervention it is. [00:17:55] And suddenly that changed from good sleep quality to poor sleep quality. [00:18:00] Eventually, with the education they get on social media, they might refer back to something [00:18:05] that happened to them in the arches. They had maybe four teeth taken out, which made [00:18:10] the arches smaller so the tongue didn’t have enough space. And [00:18:15] now again, I know the research. You could say there’s no evidence that the extractions impact [00:18:20] sleep. Yes, that’s true, but there’s evidence that posture [00:18:25] changes your airway. So have we [00:18:30] looked at how extraction affects your posture? Because if we extract and we suddenly [00:18:35] adopt the forward head posture, that will open up the airway. Hence there’s no [00:18:40] difference in airway but the posture change. And that’s another thing we see. How [00:18:45] do kids grow when they go through puberty. They change in their posture eventually [00:18:50] because the bone grows quicker than the muscles. So that means we need other participants [00:18:55] in that team approach osteopath, physiotherapists, speech therapists. [00:19:00]

Payman Langroudi: I’m really happy you’re saying this stuff here, because I remember when I became a dentist around probably the same time as you became [00:19:05] a dentist, if anyone mentioned any link between ortho and [00:19:10] posture or neck, or they were just dismissed as a, as a sort [00:19:15] of a goo goo like ridiculous. No, no evidence behind it. But the [00:19:20] idea that you can stick wires and things in the mouth on a growing child [00:19:25] and not affect posture is the most crazy idea. You know what I mean? It’s [00:19:30] so obvious to me.

Steffen Decker: Look, it comes down to dentistry is not so easy. It’s not. [00:19:35] You do one thing and it doesn’t have impact on another thing. Yeah. Functional occlusion. When [00:19:40] I seen it in my own eyes, it starts super early on and John [00:19:45] confirmed it. If you go to the symposium of John once a year, he will [00:19:50] talk a lot about airway now, about our expansion, about orthodontics, the need. It’s [00:19:55] just the beginning of this research. And when I was in training, that was in [00:20:00] 2008 when we took a bite to change the position of the [00:20:05] lower jaw, we had an osteopath coming into the clinic. And [00:20:10] what I’ve seen is the leg’s length changed, so the hips were [00:20:15] shifting by me changing the bite, which at that time, that’s a long time [00:20:20] ago. So hold on a minute, I do this. This happens with the body. [00:20:25] So very early on in my career, I was told, you cannot just look at [00:20:30] the teeth. You need to look at what is happening to your body. And we can talk about [00:20:35] airway. We can talk about posture. We can talk about behaviour. We can talk. Victoria [00:20:40] Samson is very big in gut health. But if your mouth breathing, how does it impact [00:20:45] your oral microbiome, the bacteria that you’re going to swallow into your gut? I think [00:20:50] airway.

Payman Langroudi: Is the next big thing in dentistry, like.

Steffen Decker: 100% I. And now [00:20:55] we’re talking airway kids. Airway is relatively easy to correct because [00:21:00] we have a growing individual here. We have a malleable upper jaw, which is [00:21:05] the main problem. The problem will start when they’re growing up teenagers, [00:21:10] adults. Because the longer you wait with getting bigger foundations, [00:21:15] the more invasive it gets. We need mini screws. We might need surgical assisted [00:21:20] opening of the suture. Yeah, we need double jaw surgery. And I have it every [00:21:25] week. And I have a dear friend, Christian Leonhard, in Germany. We’re doing the voice course [00:21:30] next year in Seattle. Five days, where we talk from kids to adults. [00:21:35] What’s happening? The whole realm of dentistry. And what he has to do in [00:21:40] adults, 6 or 8. Mini screws in the palate, weakening the suture dome technique [00:21:45] to get the structure weakened. So then he opens the palate versus what I [00:21:50] have to do with kids, put a device in, turn them every other day. Four weeks later. [00:21:55] Done. Finished. Phase one completed. Makes a lot of sense. So [00:22:00] my profession becomes suddenly very rewarding and compared to adult [00:22:05] orthodontics, if you do it well, considering airway, which is super complex [00:22:10] because how Christian does this diagnostic, he does much more functional occlusion [00:22:15] assessment, good diagnostic pictures. He does everything by the book choice [00:22:20] philosophy. But the treatment letter is huge. [00:22:25] What’s happening out there? Post-grads are being told a lie and bleach blonde magic [00:22:30] button eye.

Steffen Decker: The treatment plan is done for you with I accept it, [00:22:35] everything will be good. But Christian’s letter is 15 pages. [00:22:40] Maybe it’s not as easy as just pressing a button. Understand there’s a commercial [00:22:45] benefit to a company that more and more liners are being ordered. But is [00:22:50] it now a hunt to get a better discount? Or do we want to focus [00:22:55] on good quality dentistry that is being taught by the big guys like John [00:23:00] Kois and as an orthodontist? Now, if I know all the restorative problems, [00:23:05] it’s easy for me to make the swap to kids because my life gets easier. [00:23:10] Because I know now how complex an adult really is. Hence, I [00:23:15] need to charge accordingly because I know I need to deprogram. I need to find CR. [00:23:20] I need to articulate models. I need to speak to restorative dentists because orthodontics [00:23:25] alone doesn’t do it with an adult. You need restorative. You need whitening. You need all the rest [00:23:30] of it. So I need them in the boat anyway. So the treatment becomes complex. [00:23:35] And it’s not a 3000 £4,000 treatment plan any longer. Hence, [00:23:40] who can afford it? Like if I treat the case with my wife, we talk about [00:23:45] big figures because it’s orthodontics, it’s perio, [00:23:50] it’s endodontics, it’s hygiene, it’s restorative.

Steffen Decker: That adds up. Coming [00:23:55] to kids. If I can do one tool and change their life, potentially [00:24:00] forever, that’s it. No destruction, no root canal. [00:24:05] Yeah. Yes. I don’t say it all can happen like this. But [00:24:10] what I feel is, like Chris and me, we did our own research. We looked at all the [00:24:15] problems adults have. And we we basically configured a bell curve like John [00:24:20] Kois shows ten, 80%, 20% mild risk, moderate or high risk. [00:24:25] And we’ve seen all the problems in terms of airway in adults. Yeah. [00:24:30] And then we went back. Okay. Let’s go down in age and see what’s [00:24:35] happening with these problems. And they get less less less until you are [00:24:40] at an infant from 0 to 3. And guess what plays a role. Lip [00:24:45] seal. Tongue positioning. Breathing. That’s [00:24:50] it. So let’s go back to that. If a child is born, the first [00:24:55] thing a mother wants to do is feed their child. And the ideal scenario is [00:25:00] feeding with their own breast milk, ideally for 1 to 2 years. That is what we should do. [00:25:05] But bottle feeding came in easy. Open your mouth. Put it in. [00:25:10] So with breastfeeding you need a lot of muscle activity. So that creates stimulus [00:25:15] on the bone structure to grow fundamentally. So what happens if [00:25:20] a child is tongue tied and they don’t get the tongue mobility.

Steffen Decker: Tongue strength [00:25:25] to extract milk of a mum. If it’s bad enough the mum might get concerned. [00:25:30] They go to a dentist. The dentist says to them oh no, there’s nothing [00:25:35] for you. Try harder or use the bottle. They missed an opportunity [00:25:40] here because eventually it’s a tongue mobility. The tongue function. [00:25:45] Also bottle feeding was only invented for the 4% of the [00:25:50] kids. They needed it because they couldn’t be fed. But 96% should have been [00:25:55] still receiving breastfeeding. Now it’s the opposite. So they’re not being [00:26:00] breastfed. So there’s no muscle structure, no strength. Then also folic acid. Folic [00:26:05] acid research shows it’s linked to tethered tissue. So we [00:26:10] get supplements with folic acid. It, we get more theta tissue tongue [00:26:15] function decreases. The funding for tongue tie release is gone in [00:26:20] NHS. So there’s a lot of kids out there who struggle to [00:26:25] extract milk. That creates emotional frustration for mother. I [00:26:30] can’t feed my child. The child is not being fed. The sleeps will be disturbed. Waking [00:26:35] up every so often that already has an impact on the family. What [00:26:40] should you have done? Maybe address the tongue and the function is back and the child [00:26:45] can grow. That’s just one example. Go to a school class. How [00:26:50] many kids sit there in the school? In primary school?

[TRANSITION]: Mouth [00:26:55] breathing.

Steffen Decker: Mouth breathing. Look for an interview with Harry Kane by [00:27:00] Munich, now former Tottenham player.

Payman Langroudi: Yeah, yeah. [00:27:05] Classical.

Steffen Decker: Classical. How come that he’s a professional [00:27:10] footballer? No medical professional told him. Oh, let’s look at your tongue. [00:27:15] Tongue positioning, maybe. We have to increase your tongue space to make you breathe [00:27:20] at night. How is that happening? That professional athletes don’t know this [00:27:25] yet. That tongue. Tongue positioning. Tongue space can improve your airway, [00:27:30] your sleep quality. So Saggi in LA is doing talking all about [00:27:35] it. He was trained by Christian Gimeno. Christian Gimeno in LA. Discovered [00:27:40] the word sleep apnoea. He discovered it. And he says if [00:27:45] you need to expand in a child, it’s already too late. [00:27:50] What? Christian Gimeno said if you.

[TRANSITION]: What did he [00:27:55] mean by that?

Steffen Decker: That means you start already too late. You should have focus on tongue positioning. Tongue function. [00:28:00] Because in a baby you can malleable the palate with your finger. So [00:28:05] your tongue should do that all day, every day. If the tongue is not [00:28:10] there, the palate will be narrow. Hence, we might develop a cross by [00:28:15] going back to Jonquils. The teeth are erupting. We are biting on these upper front teeth. [00:28:20] We drifting forward. That will cause trauma. On the lower teeth. On the upper teeth. The [00:28:25] roots moving out. We are getting where they come back. As an adult, we see the gum receding bone. [00:28:30] Look at it. What’s happening? You missed an opportunity. So when you need [00:28:35] to expand, it’s already too late because you missed a lot of opportunities to see very [00:28:40] early on in life. So what is my job to do? Or what is the job of any [00:28:45] dentist is to at least detect there could be a potential problem. [00:28:50] Is your child not speaking properly? Why? Look at the tongue. Look [00:28:55] at the tongue spacing. Is your child not feeding? Is it avoiding certain food like chewy [00:29:00] food because they struggle to chew? Is it impacting their mental health? Do [00:29:05] they have trauma? Yeah, there’s a lot of things to consider. I’m not saying everyone should [00:29:10] treat children, but I think everyone should at least know about that. [00:29:15] It’s much easier than just single tooth dentistry. And if you don’t know, go [00:29:20] to someone who might know. So education is my priority now because [00:29:25] me as a professional.

[TRANSITION]: You want to get this.

Payman Langroudi: Story out there.

[TRANSITION]: You need to.

Payman Langroudi: I’ve got a couple of questions around [00:29:30] it though. Number one, are we well behind on this in the UK compared to other countries? [00:29:35] Because I feel like I feel like the UK.

[TRANSITION]: It’s a worldwide problem. Oh really?

Steffen Decker: I teach in whole. [00:29:40]

[TRANSITION]: World.

Payman Langroudi: In the US and deceptive is much bigger than it is here.

Steffen Decker: It’s much [00:29:45] bigger in the dental world. If you speak to key opinion leaders in the [00:29:50] prevention side of things, they are dentists and a lot of them are trained [00:29:55] because John Kois knows now because I’m there as well. So every year we’re [00:30:00] talking about it. So there’s a lot of groups in the US who do To podcasts [00:30:05] and to talk about it. But they’re dentists, not orthodontists. [00:30:10] Orthodontists? What are you doing? This should be us helping the dentist [00:30:15] because we’re getting eventually also back the patients. We see the kids early. We [00:30:20] see the teenagers. We see the adults. So let the dentists do what they’re good at is restoring teeth. So [00:30:25] in Germany, it’s the same. This airway, like you mentioned, is for [00:30:30] me as well. I think this is where we need to look at in future. And Apple knows this. [00:30:35] Sleep apnoea is on the Apple Watch. Yeah we have the.

Payman Langroudi: Sleep apnoea [00:30:40] and adults has been linked to all sorts of heart conditions strokes and everything. Right.

[TRANSITION]: So [00:30:45] how about dyslexia.

Steffen Decker: In kids and.

[TRANSITION]: All the other ADHD. It’s [00:30:50] become such.

Payman Langroudi: A big area.

Steffen Decker: Adults have these problems. But how about attention deficit hyperactivity [00:30:55] syndrome in kids it starts just kids adapt really well. [00:31:00] And then later on when we become maybe a bit bigger in adulthood. It impacts adults [00:31:05] in kids. Generally, what is the first point of call is adenoids. Tonsils. We [00:31:10] breathe through our mouth that the air is not being cleaned up, hence [00:31:15] our adenoids. Tonsils get overwhelmed with dirty bacteria. They swell up. What’s the first [00:31:20] point of call in a child below six? Remove them. That’s happening. They’re [00:31:25] getting ear infections. Let’s put a tube in there. That’s happening every [00:31:30] day. How about in a child? Okay, let’s get the tongue space. Go. [00:31:35] Let’s get tongue function up. Lip seal, nasal breathing. Let’s get the filtration going. [00:31:40] Maybe the size of the tonsils will decrease. Yes, I do agree. [00:31:45] We might outgrow the tonsils because the facial structure is growing later [00:31:50] on. But this alone is not harming the child. They [00:31:55] have a crossbite generally. So by correcting a bite, a crossbite is [00:32:00] not making them.

[TRANSITION]: Feel.

Steffen Decker: Worse.

[TRANSITION]: So it’s an.

Steffen Decker: Easy intervention we can do [00:32:05] eventually to help. But yes, we need an INT. Yes, we need to assess allergies [00:32:10] and all the rest. Speech therapy Myofunctional therapy. So it’s not an orthodontist alone. It’s [00:32:15] a whole team approach because airway is not expand the palate. We can breathe. No [00:32:20] it’s tongue function. It’s adenoids, tonsils, allergies, septum deviation. [00:32:25] It’s a lot to this story. But the challenge is to connect [00:32:30] these professionals, to think alike, to get a holistic approach to [00:32:35] their child. So now comes the problem again. Every one of these professionals has [00:32:40] a charge. If I want to do a child correctly, [00:32:45] they need to see eventually an ENT, a myofunctional, therapist, osteo [00:32:50] circle orthodontist, dentist. They all want a charge. [00:32:55] So now it becomes a luxury good for a child. But [00:33:00] where’s the money from the NHS going? It’s going into treating [00:33:05] symptoms. 130 million are being spent a year in filling baby [00:33:10] teeth and extracting baby teeth. 130 million. That’s just baby teeth. [00:33:15] How? Why can we not go into schools and talk about [00:33:20] mouth breathing? The impact it can have? Why do you not create awareness? How kids should clean their teeth. [00:33:25] That fizzy is not good for them. It’s easy prevention things we can do. Paediatric and orthodontics. [00:33:30] Why cannot invest that money in these things?

Payman Langroudi: I think look, when [00:33:35] something’s new, it tends to be expensive. When something’s [00:33:40] out of the ordinary, it tends to be expensive. Um, if it was mainstream, [00:33:45] it would be different, right? There would be the kind of specialists that are trained [00:33:50] in 2 or 3 of these disciplines, for instance. But I’m kind of interested in, [00:33:55] you know, you as an expert by its very nature, if you’re at the tip [00:34:00] of the spear, you’re you’ve got opinions, you’ve got [00:34:05] you’re trying things that aren’t in the sort of the research [00:34:10] and the teaching. How do you how do you balance that with when you’re talking to [00:34:15] a patient, explaining that this is, you know, this is your opinion [00:34:20] and you, you and your group’s opinion, let’s say and not and not what’s [00:34:25] out there, you know, in the in the research because the research is 20 years behind generally. Yeah. [00:34:30]

[TRANSITION]: The thing is what.

Steffen Decker: Happens is parents [00:34:35] nowadays, they’re very well educated.

[TRANSITION]: Yeah.

Steffen Decker: They get the information [00:34:40] on social media. So their gut feeling says something is [00:34:45] not right. Yeah. They’re going to professional and they’ve been told [00:34:50] there’s nothing we can do for your child. Now come back when they’re in secondary [00:34:55] school Every day I have this story. Then you start explaining [00:35:00] what is the link between this and this and this, and they [00:35:05] get emotional. They said, hold on a minute. I went with [00:35:10] these problems to the professionals. They all told me I’m there. There’s nothing there. [00:35:15] You overthink things you do, but you are telling me I was right. So [00:35:20] I don’t even talk about that. I’m one in a lot of things. We don’t [00:35:25] think like that because they know. They know.

Payman Langroudi: They feel it in themselves.

Steffen Decker: They feel they [00:35:30] know when a child is not feeding. Yeah, there’s an issue. Why is my child not taking [00:35:35] my. There is something wrong with me. They’re asking the question. They’re going on social media. What’s wrong with me? [00:35:40] And they’re getting answers. So if I give them an answer where the potential link is be, [00:35:45] they say, you’re right. This happened before, for example.

Payman Langroudi: And that’s a massively growing [00:35:50] area. But but does it not keep you up at night that something could go wrong [00:35:55] with one of these kids?

[TRANSITION]: No, because.

Payman Langroudi: Then some expert who’s an NHS trained orthodontist, [00:36:00] who’s now the expert legal advice says this isn’t the normal way of doing it. [00:36:05] And and something.

[TRANSITION]: I look.

Steffen Decker: I give you an example. I [00:36:10] have a kid in treatment with down syndrome. Yeah. [00:36:15] Down syndrome children have a very low muscle tonus. Yeah. And [00:36:20] they tend to have a big tongue. Or you could say they don’t have a big tongue. [00:36:25] They have a small jaw to fit the tongue. Yeah. This child has a CPAp [00:36:30] machine since he’s four years old. Wow.

[TRANSITION]: Poor thing.

Steffen Decker: And [00:36:35] the mum hates the machine because the child maximum one hour a night. He [00:36:40] uses it because he can’t cope with it. The mum came to me for advice [00:36:45] and I said to them very clearly. Look, there’s not a lot of [00:36:50] research there, but I can try my very best to create [00:36:55] space for this tongue to work better. Are you with me in [00:37:00] this? And the mom gets emotional. Please help my son. We [00:37:05] are texting nearly every day. She keeps me updated how the child is changing. What [00:37:10] am I doing wrong? At this point in time when [00:37:15] the mom wants me to do this, she’s aware of everything I do. I keep in close communication [00:37:20] with the mom and she tells me everything. If something would go in a not the right direction, [00:37:25] I would remove it immediately. She knows that and she knows as well as I would [00:37:30] do 2 or 3 rounds of expansion if I need to. And guess what? I’m not charging her for the extra [00:37:35] rounds because I want this. This is the emotion. This is connection between [00:37:40] me and my patient. I don’t care if I get attacked for that, if I get attacked [00:37:45] for helping a child, for potentially changing [00:37:50] their life. God, mark my word.

Payman Langroudi: I felt the same. [00:37:55] You know, when we started teeth whitening, it was illegal. And, uh, people [00:38:00] kept asking me this question. What if. What if, you know, for 12 years, we sold it illegally [00:38:05] to dentists. And I felt the same. If the if the alternative is to [00:38:10] drill teeth and stick veneers on, and someone wants to attack me for selling bleach, [00:38:15] then I’m up for that fight, you know, so but I get I get what you’re saying. [00:38:20]

[TRANSITION]: And I also.

Steffen Decker: Don’t like what’s happening now because I have a lot of podcasts, [00:38:25] a lot of, um, messaging I have out there. Sometimes [00:38:30] I get dentists coming to me with their children.

[TRANSITION]: Sure. Yeah.

Steffen Decker: Because [00:38:35] their child is looking like this. Yeah. And guess what? She’s suffering. [00:38:40] So I’ve heard you, you know, I don’t know anything about it. Can you help [00:38:45] my daughter? I helped their daughter. Suddenly these dentists become my biggest [00:38:50] referring practice because they’ve seen it with their own eyes. What I’ve [00:38:55] done changed their kids life and hence their parents life. Look, I get emotional. [00:39:00] What am I doing wrong? I’m helping. Research needs to happen. But [00:39:05] how do you get control? Research with control groups. It’s impossible [00:39:10] because you cannot do proactive. Say this. I want to control fine twins. [00:39:15] And one you treat and one you don’t. One has sleep apnoea. One doesn’t. Where do you make the difference? [00:39:20] It’s really hard to get the research and talk to saga. In US talks a lot about it to get high level [00:39:25] evidence. It’s very difficult. Also airway topic is not [00:39:30] just okay let’s see. We expanding a pallet. Does the airway change. You get [00:39:35] this port of 3040 patients. If not everyone change. Why? Because they [00:39:40] all had allergies for lactose or whatever. You didn’t look at that point. You [00:39:45] didn’t look at the rest of it. It’s too complex that you can just say, we do one thing [00:39:50] and something.

Payman Langroudi: Changes early on as.

[TRANSITION]: Well. It’s too.

Steffen Decker: Early. So, um, but if [00:39:55] you talk to a mum, we have dry lips. We know this child is mouth breathing. [00:40:00] You ask them, how is the child sleeping? Is it dry now? Does it need to wake [00:40:05] up at Night-Time to get some water? One says yes. Then you know, mouth breathing. Hence [00:40:10] more bacteria through the mouth. Hence I expect infections. Ask [00:40:15] them, did you have any problems with adenoids? Tonsils? Ear infections? Eventually [00:40:20] you get the answer. Oh yeah, we have ear infections all the time. We have tons of infections. [00:40:25] Four times five times a year. We get told to get antibiotics. What [00:40:30] does antibiotics do to your child’s gut? Kills [00:40:35] it down. So again fire is on symptom. Fire out. [00:40:40] But where’s the smoke of this? Where we need to see the smoke. So, [00:40:45] um, you see signs and after when you do that for, you see a lot of signs. [00:40:50] Speech. Yeah. Dry lips, face structure, tired [00:40:55] eyes. There’s so many signs which we can learn. There’s a list of ten signs [00:41:00] you can learn that tick box, any of these signs. Then we have a high risk for sleep disordered breathing. [00:41:05] It’s easy. You can learn. That’s research study published this this new research. [00:41:10]

Steffen Decker: But as a professional, I think we have to be open to [00:41:15] accept new research and to say, okay, you know, everyone’s talking about maybe [00:41:20] there’s something to it. Yes. It’s not black and white, but what I want [00:41:25] is to people be open, say, just ask some questions. Because if this is your [00:41:30] princess in the chair, struggling with breathing, [00:41:35] with bullying trauma, how would you feel as a parent, not as a dentist [00:41:40] who knows all the research? Would you not say, I want to try this. There’s [00:41:45] nothing wrong with trying. And guess what? If I am the one who changed [00:41:50] that? What makes me? I am the hero forever. So they will never [00:41:55] leave my sight and they wont. Dentistry eventually on the side because they say I [00:42:00] trust you and I have patients flying in from Hong Kong, Norway, Portugal [00:42:05] to me to Amersham. Old Amersham clinic is close to Heathrow for [00:42:10] advice. I don’t actually want people flying into me because that’s [00:42:15] a lot of responsibility, a lot of pressure. How about I trained local dentists [00:42:20] or orthodontists in that community, what they should do, and I helped the children [00:42:25] in their community.

Payman Langroudi: So let’s get to that. Are you happy with a dentist, a GDP treating [00:42:30] seven year olds, eight year olds with orthodontics, bearing [00:42:35] in mind the airway? Or is that really a specialist area? Well, it is number one. Number [00:42:40] two, what should a dentist look out for at those ages?

[TRANSITION]: Okay, there.

Steffen Decker: Are two aspects orthodontists [00:42:45] should do that.

[TRANSITION]: For sure.

Steffen Decker: They should do because they [00:42:50] have the fundamental training in growth and development. There are a lot of steps [00:42:55] ahead of a general dentist in terms of growth and development. Yeah, but [00:43:00] dentists seem to invest more [00:43:05] professional time in their education than orthodontists. Orthodontists [00:43:10] go to an orthodontic conference. Dentists go everywhere to educate them. [00:43:15] So end of the day, if you have the right education, [00:43:20] you can do kids. It comes always back to education. [00:43:25] That’s why I’m training. Good education. I have a one year [00:43:30] course, one year a diploma course certified by the University of Luxembourg, [00:43:35] which gives them good idea about growth and development, About [00:43:40] biomechanics. About clear aligners. Clear aligners is not a magic wand. It’s a plastic [00:43:45] and how to treat children. And I offer them me as a mentor [00:43:50] to four questions the whole way through. So if they would have a question, they [00:43:55] would come to me. If it’s too challenging for them, guess what? They refer to me. Good, [00:44:00] because they know their limitations a dentist. What I see [00:44:05] nowadays a lot is they go to a course maybe two days.

Steffen Decker: They may believe [00:44:10] you can do alignment, forget functional occlusion, forget all the rest. Eventually [00:44:15] they fail. They are out of their limit zone. They don’t know what to do. Bite [00:44:20] is open. Functional occlusion is all over. They didn’t have the CR [00:44:25] position before they moved the teeth so it failed. They don’t know why. So they [00:44:30] thought they have to go to education. They didn’t and they’re doing it on adults. Now we [00:44:35] talk about kids. It’s the same thing if you know what you’re doing and you have someone you can ask [00:44:40] for help if you need to. Maybe yes, because end of the day, we need [00:44:45] to prevent. My mission is to help children. If it’s [00:44:50] a paediatric dentist or a dentist or an orthodontist, which I still believe we should be [00:44:55] our job. But when do we get our patients referred to? When they’re teenagers? Because [00:45:00] the dentist don’t see it. But if dentists recognise it and we talk about it now, in a minute, [00:45:05] the signs and they would start referring to an orthodontist. And what’s happening right now? The [00:45:10] orthodontist is too early.

[TRANSITION]: Yeah.

Payman Langroudi: The right orthodontist is going to have to be right now.

[TRANSITION]: It needs to be the right orthodontist [00:45:15] again with the right training because.

Steffen Decker: It falls down again. I have a lot of patients who went to a dentist. [00:45:20] The dentist seen a problem, refer to an orthodontist, said, no, come back in secondary [00:45:25] school. We might have to extract four teeth or double jaw surgery. This is not good [00:45:30] enough. If the dentist recognise it and refer to an orthodontist, they should be able to [00:45:35] say thank you so much for this amazing referral and write a nice letter back [00:45:40] and give them back the restorative. That’s how it should be. Back to where we used to be 20 years ago. [00:45:45] We got referrals from dentists or dentists were not interested in alignment. Why [00:45:50] can we not do that again? Have a nice work relationship instead of everyone from us looking for ourselves. [00:45:55]

Payman Langroudi: For the same adult patients? Right? Right. Yeah.

Steffen Decker: And what are the signs? There [00:46:00] are ten things we need to look out for in children. Mouth breathing.

Payman Langroudi: This is at seven [00:46:05] years old. Yeah.

[TRANSITION]: Yeah.

Steffen Decker: Paediatric disordered breathing. [00:46:10] Yes. Sleep disordered breathing. Doctor Sagi Ferris six. It’s called. [00:46:15] Yeah. You can download it online lah. Mouth breathing. Tension [00:46:20] in the muscle. In the mentalis muscles. Tonsil infections. Increased. [00:46:25] Tonsils more than 50%. Tongue tie. Tongue tie is [00:46:30] not. Just untie your tongue to where the tip is. Tie which everyone should [00:46:35] recognise. It’s also a tongue restriction, which is the back of the tongue, kind [00:46:40] of which is hard to diagnose. Narrow arches, really [00:46:45] easy grinding if if kids are [00:46:50] grinding. Yeah. And face structure. Tired eyes, venous pooling. [00:46:55] There are a few things which are easy to detect in adults. It becomes a [00:47:00] bit more complex because we see imprints of the teeth on the tongue, because the tongue [00:47:05] is too big for the jaw. So that’s called tongue overflow. Then we can [00:47:10] do simple exercise to ask the kids to lift their tongue up when their mouth is open.

[TRANSITION]: That’s [00:47:15] the tip of the tongue.

Steffen Decker: Touch the tip of the teeth. Then you see anterior restriction. Then [00:47:20] you can ask them to suck their tongue up.

[TRANSITION]: To the palate.

Steffen Decker: To the palate. Can they do [00:47:25] that? And you will be astonished that a lot of them can’t. And guess what [00:47:30] the parent is doing in the corner.

Payman Langroudi: Same thing.

[TRANSITION]: And they say to me, hold [00:47:35] on a minute.

Steffen Decker: I can’t do that. I’m snoring at night. I’m struggling. There’s your [00:47:40] next patient. So A-Rod is a big topic because it’s a lot [00:47:45] of awareness. And we have look, we treat a lot of symptoms. We have these sleeping devices [00:47:50] now moving the jaw forward. Yeah. Big industry. Yeah. But it’s [00:47:55] symptomatic treatment moving the jaw forward, which means posture. Open the airway. [00:48:00] What does it do to the teeth? Because there’s a force. Think [00:48:05] about it. It’s short term. Okay. But should we not go to the source of [00:48:10] the problem? Also, what does sleep do to the mental health of an adult? [00:48:15] Ask these questions. How are you sleeping? Or. I sleep only three four hours a night. [00:48:20] And do you take any medication? Oh, yeah. I take antidepressants and [00:48:25] I drink at night. I’ve had it all in a chair.

Payman Langroudi: There’s a lot of it about. [00:48:30] There’s a lot of it about.

[TRANSITION]: If adults.

Steffen Decker: Struggling, they might have [00:48:35] really big issues and then they work in the city 24 over seven. I had these patients in my chair in Harley [00:48:40] Street. Antidepressants, ADHD medication, drinking themselves to sleep most nights. [00:48:45] What is your life expectancy? Not very well. So [00:48:50] it comes back to one thing prevention. So this ferry six [00:48:55] or adults, it’s called the ferry six plus four because we have ten points you can [00:49:00] download. I have Ferris. Ferris.

[TRANSITION]: Like Ferris. How do you.

Steffen Decker: Spell functional airway [00:49:05] resistance assessment?

[TRANSITION]: Oh I see okay. Yeah.

Steffen Decker: So it’s doctor Tsurusaki Institute [00:49:10] and Breathe Institute. Com download it. It’s an easy assessment since. [00:49:15]

Payman Langroudi: You’ve moved on so much from your original training. From [00:49:20] ortho training? If you were the king of the world now, would you change ortho [00:49:25] training? I mean, for instance, this thing about getting everyone to class Plus one.

[TRANSITION]: Would [00:49:30] you change that?

Steffen Decker: John Coy is teased about function. [00:49:35] How do these jaws move when you speak and when you do? What [00:49:40] is an angle? Class one it’s a static situation, a [00:49:45] scenario in one position in time. This is not.

[TRANSITION]: Real, but.

Payman Langroudi: Also sometimes [00:49:50] you’re forcing people into class one when it’s not. When when it’s constricting.

[TRANSITION]: Amazing. [00:49:55]

Payman Langroudi: Is that correct?

[TRANSITION]: Look, we.

Steffen Decker: Have a class two skeletal. A lot of Asians Indians [00:50:00] have class twos, right? Yeah. So now we’re using a line of biomechanics. [00:50:05] We’re doing sequential digitalisation moving into a static angle [00:50:10] class one. But unfortunately the jaw movement didn’t change [00:50:15] it still coming forward because we still need to to be able to function. So what’s [00:50:20] the what the brain is going to do. You hit the front teeth. The brain’s going to fire up back [00:50:25] clench. You get a lateral open bite.

[TRANSITION]: Which [00:50:30] is common.

Steffen Decker: Which is common, yeah. Common side effect of a line. [00:50:35] Orthodontics. Nothing to do with the line. Orthodontics. Wrong plan. It’s [00:50:40] your planification. So functional occlusion all over. So [00:50:45] this exactly comes back to education. You cannot [00:50:50] move everything into class one. It might work well in some cases, but it might [00:50:55] fail dramatically in other cases. And when we see cases for second opinion this [00:51:00] is always the case. They’re going to the left, to the right, forward, backward. And [00:51:05] they can’t bite anymore. So then we have a complaint patient there. [00:51:10] And then we have to protect the dentist and says okay dentist, [00:51:15] did you do de-programme the bite? Did you assess CR before you moved these teeth? No, [00:51:20] I didn’t. So that was a lack of education. So then we have to fix it without [00:51:25] causing the dentist any trouble. Yeah, so. But what a lot of [00:51:30] my. Sometimes it even happens to people I train when their dentist that at the end [00:51:35] of the training they say to me, you know what, Stefan? I will not do orthodontics. And [00:51:40] I say to him, that’s very brave of you, but I understand it because you understood [00:51:45] this is too complex, especially adults, for me to make this. [00:51:50]

Steffen Decker: Now, let me just refer to you the orthodontics. And I do the veneers, the bonding, [00:51:55] whatever I need. This is a very better relationship, I think, before [00:52:00] it comes to complain. And now we have clinics hunting for this biggest [00:52:05] discount number. It’s a number game when you treat three, [00:52:10] four, 500 kids adults with aligners, it’s just a matter of [00:52:15] time that it fails. Yeah, that you get the complaint. [00:52:20] Yeah. So then you as a business you have to deal with the complaint. Is that what you [00:52:25] want to do in your business, dealing with complaint patients all the time, or do you want to have a kid coming [00:52:30] into your clinic says, hi, Stefan, can I give you a hug? What [00:52:35] do you want in your business? You want a happy mind or you want this suing [00:52:40] mentality? You need to be a damn good dentist to do adult orthodontics [00:52:45] and restorative. You need to be good. You need to know your stuff. So that comes back [00:52:50] to diagnostic. Gandhi said. Three quarters is diagnostic. The rest is easy. [00:52:55] But unfortunately now it feels like diagnostic is a quarter and the rest is AI. [00:53:00]

Payman Langroudi: Well, look, we’re at that point. Yeah. I mean, at the same time, if that hadn’t have [00:53:05] happened, you wouldn’t now be using aligners on these kids. You know, it’s just [00:53:10] it’s you know, you’ve got to understand that that’s the sort of the natural [00:53:15] history of a product here. I know what you’re saying about manufacturers are looking for profit the whole time [00:53:20] and and you know, you as the as the specialist needs to translate [00:53:25] that into treatment options and and clear things. But you know, [00:53:30] it’s it’s just the way. I mean, we’ve both been around long enough to see trends [00:53:35] come and go. Are you still stuck on lingo for adults? [00:53:40] Like, if I was an adult coming to see you, would you? And I wanted invisible.

[TRANSITION]: What [00:53:45] I would say to you is I.

Payman Langroudi: Took lingual.

[TRANSITION]: Number one.

Steffen Decker: Let’s do diagnostics. Yeah. [00:53:50] If we. The main problem is, for example, a [00:53:55] curve of spee. Yeah. Where we physically need to extrude move teeth [00:54:00] out of the bone. We know aligners is the worst tool. Yeah. [00:54:05] So if that would be the case. So we have a deep bite curve for spee. Lower [00:54:10] teeth are reclined crowd. That’s a classic aligner case. Yeah. You will fight [00:54:15] a long time with an aligner with this case if you get it managed at [00:54:20] all and correct the bite with a lingual. You don’t need to do anything because you put [00:54:25] a straight wire in. The wire will lift the bite. So in my consultation, [00:54:30] I will tell the patient, this is your problem. This is the best tool for the problem. [00:54:35] But I understand from a comfort point of view from a you [00:54:40] coming physically to me to make adjustment. It’s inconvenient because your tongue will suffer. [00:54:45] You need to physically come and see me for me to make the adjustment. If you want to travel the world, never [00:54:50] come and see me. I can do remote monitoring. I have an aligner case. You don’t need to come in, [00:54:55] but it might take double the time. And it requires [00:55:00] your commitment the whole way through. [00:55:05] So now we are not in Asia. We are in Western Europe, my colleagues in Asia, [00:55:10] orthodontists. They can do whatever they want complexity wise because Asians, [00:55:15] you tell them what to do.

[TRANSITION]: They will do it No.

Steffen Decker: Here. Different mentality, [00:55:20] different area. So for an adult, my personal experience is after eight [00:55:25] months, ten months, they lose the interest. Complaint drops. So [00:55:30] hence you might not get the end result. But then a restorative dance [00:55:35] has good options because he can cover it. He can cover. He can increase [00:55:40] the bite. He can cover my malalignment with bonding. So the picture [00:55:45] on social media looks great. Me as an orthodontist, I [00:55:50] don’t have that. I’m not restorative dentist I need to refer on. So for me the expectation I need to have alignment. [00:55:55] So I will tell a professional, what do you want? Do you want efficiency? Which [00:56:00] means discomfort. And you need to physically come and see me. But it’s discreet. [00:56:05] You don’t see any lingual is completely discreet. Aligners is not [00:56:10] completely discreet. You have attachments. You have a plastic. Or do you want [00:56:15] comfort? What do you want? And my opinion is if I talk to professionals, singers, [00:56:20] actors, businessmen. No, Stefan, you know what? You should do your job. I [00:56:25] will deal with it. And I’ve treated over 1800 lingual cases now. I’ve done a fair. [00:56:30]

[TRANSITION]: Bit of 1800. Yeah.

Payman Langroudi: My goodness.

Steffen Decker: So I’ve done a fair bit of reading. And to answer [00:56:35] your question, most adults choose lingual. In my [00:56:40] clinic, the only adults I would opt for an aligner is easy [00:56:45] alignment, moving out, spacing, or where the kids [00:56:50] have the liners already and they want to do it with their kids together. But I will tell them [00:56:55] everything. And now comes the power of an orthodontist. Again. How [00:57:00] about combining techniques? Why not choose the best of [00:57:05] each world? Why not align the upper with the aligner? No speech impact, [00:57:10] nothing. No very discreet. And the lower curve of spee. U [00:57:15] do a lingual for four months.

[TRANSITION]: How interesting.

Steffen Decker: Take it out. Finish [00:57:20] with a liner. We call this hybrid approach. Why do you not use your strength [00:57:25] as an orthodontic specialist to combine techniques? Why do you need to do everything with [00:57:30] lines when you have rotated teeth? Very rotated teeth? Why would you try [00:57:35] that with an aligner? Put three brackets on. Rotate the tooth, take [00:57:40] it away and finish it. Easy. It’s easy because [00:57:45] it’s efficient. But for some reason we get pushed into this world. Everything [00:57:50] can be done with lines, I agree. You can do every malocclusion with an aligner, [00:57:55] but is it the most efficient device for that problem? [00:58:00] No, not all the time. But I love it for finishing. I [00:58:05] love it for certain movements. And I have this frank conversation with the patient. Who are you? Teenagers? [00:58:10] The same teenager. Who are you? What is important to you? I [00:58:15] do. Contact, sport. I’m very disciplined. I’m a professional. Or junior [00:58:20] tennis player? I know they do what they want to do. And a line up. Please do a line up. But [00:58:25] a lot of kids says. You know what? I can’t be bothered wearing that thing. [00:58:30] Put braces on, please. Because it will be a disaster. And the minute the parent pays, [00:58:35] they have expectations.

[TRANSITION]: So what.

Payman Langroudi: You’re saying is it’s very dependent on both the clinical and the social [00:58:40] situation in that particular.

[TRANSITION]: Case. Do you need to have that conversation? You need to actually ask.

Steffen Decker: It cannot be [00:58:45] an online questionnaire. Alina, Alina, Alina, it’s not like that. You need to have a conversation, [00:58:50] you know.

[TRANSITION]: What are you.

Payman Langroudi: I had one of my kids went through buckle, going every month [00:58:55] to the orthodontist, and my other kid had Invisalign with remote monitoring. And [00:59:00] my God, what a difference. What a brilliant experience that second one was for for [00:59:05] the kid.

[TRANSITION]: 100%.

Payman Langroudi: I mean, I when my son had the buckle, [00:59:10] I knew my daughter wouldn’t be the kind of person to put up with that. And I said to my wife, [00:59:15] I’m not sure, you know, she’s not going to be able to do it. And then she happened to go to an orthodontist who went the other direction, [00:59:20] and she just managed it so easily.

Steffen Decker: But isn’t that beautiful that we have options?

[TRANSITION]: Yeah, yeah. [00:59:25]

Steffen Decker: But we need to understand the needs of a patient. I have a lot of kids in [00:59:30] boarding school. Harrow on the Hill, Eton that I can’t do. Fixed braces. How is it possible [00:59:35] for a parent who lives in Hong Kong to take their kid out of school? Bring it to me for five minute appointment. [00:59:40] It’s not possible. Hence, I have to do aligners. I have to do remote monitoring. [00:59:45] But I make it very clear if you don’t do it, it’s not going [00:59:50] to work. You patient, you need to be able to commit. Can you do that? [00:59:55] And they say yes or no. If I’m if I’m not sure, I say to the parent, I’m not [01:00:00] sure if it will work. So plan B is fixed. If he doesn’t do that I will put fix on immediately. [01:00:05] So the beauty is the options. But if you a lot of orthodontists now [01:00:10] they focus completely on aligner world, no lingual, no buckle. They lose their skill. [01:00:15] They lose their differentiation between an orthodontist and a dentist. So [01:00:20] they are not different anymore. So they limit themselves to one technology, [01:00:25] even though they knew the technology. But lingual lives and breathes with [01:00:30] experience.

Payman Langroudi: A lot of lot of orthodontists don’t do lingual, right. They know how to do lingual.

[TRANSITION]: Why? [01:00:35] Because they.

Payman Langroudi: Didn’t. Lingual is difficult.

[TRANSITION]: It is bad.

Steffen Decker: Luck. End [01:00:40] of the day, Lewis Hamilton didn’t become a Formula one driver with one car. It’s again [01:00:45] and again and again and again.

Payman Langroudi: I’ve got a question for you. You must be positioned at the higher end. [01:00:50] Right. Like how much do you charge for a lingual case. A typical.

[TRANSITION]: One between.

Steffen Decker: 8 and £12,000.

[TRANSITION]: Yeah. [01:00:55]

Payman Langroudi: And you don’t you say you don’t do any marketing. No. So is it just [01:01:00] your passion that comes through and then word of mouth. Yes. Is that it. Is that. Yeah. And [01:01:05] it’s quite an interesting lesson isn’t it, that, you know, you’re charging £12,000 for something that [01:01:10] potentially people can get for 3500, and yet you’re busy [01:01:15] as hell. Yeah, yeah. And and it comes. It comes out in your voice. You adore [01:01:20] it. You’re so passionate about it. Yeah. And that rubs off on patients and patients. Tell patients. [01:01:25] Go and see my guy. You know, it’s so interesting. I’ve got another question for you. You obviously love learning. [01:01:30]

[TRANSITION]: Yeah.

Payman Langroudi: So why can’t you learn to do the bonding?

[TRANSITION]: Or [01:01:35] is that. Or is that. No.

Payman Langroudi: Is that a red line?

[TRANSITION]: Absolutely. Look, [01:01:40] you know.

Steffen Decker: What? I had this discussion with Coleman, my wife. A lot of time, I [01:01:45] said, why am I not doing the bonding? Yeah. Because I love cosmetics, I love [01:01:50] it.

Payman Langroudi: If you’re learning new things every day anyway, you might as well learn this.

Steffen Decker: I can do it. But [01:01:55] now, financially speaking, I’m charging what I charge.

[TRANSITION]: Yeah.

Steffen Decker: Hourly [01:02:00] rate. Bonding with the competition. We charge about For [01:02:05] £500 for bonding. Yeah.

[TRANSITION]: Doesn’t work.

Payman Langroudi: It doesn’t? Does [01:02:10] it interest you?

Steffen Decker: I am really good in what I do. I could do it, but [01:02:15] my skill is too high to do bonding. So I let the people do [01:02:20] it who have the passion for bonding. But as a business speaking, their day [01:02:25] rate is very limited. There’s only so much bonding. How many.

[TRANSITION]: Cases? [01:02:30]

Payman Langroudi: How many case starts do you do a year? Do you do a month?

[TRANSITION]: Well. [01:02:35]

Steffen Decker: We have now a new business, but the new business still has potential [01:02:40] to grow, especially with Dental monitoring. So I would say I treat about uh, [01:02:45] with kids now 180 kids with aligners. No, I don’t even [01:02:50] know how many per year. Yeah, yeah, I do probably then I do a lot of, um, removal [01:02:55] armies, like rapid maxillary expansion for bone expansion, a lot of them maybe 80 [01:03:00] a year. Then I do buccal braces, very limited. Maybe 1% is buckle [01:03:05] and most adults have lingo. But the.

[TRANSITION]: Adults? How many of those [01:03:10] do you do?

Steffen Decker: Now? Probably 30 only, but I used to do over 300 a year. But [01:03:15] my target changed. I focus on the kids and prevention and I have the parents. [01:03:20] But am I? Am I sad about it? No.

[TRANSITION]: I can change. I don’t look [01:03:25] sad.

Steffen Decker: I can change tomorrow to go to adults again. And I was thinking about again. [01:03:30] But I’m in a stage of my career. I want to train my associates to be me, [01:03:35] so I want to train even a dentist. Coming back to your training, I can train [01:03:40] a dentist to put lingual braces on. I can because you have also passive self-ligating [01:03:45] with lingual. I have a dear friend in Rome. I can do anything because my [01:03:50] my associates, my students, they know the benefit curve of spee [01:03:55] extrusion and so on, says Stefan. I want to do lingual. I said, okay, do it. Yes, they really struggle at the beginning [01:04:00] because my girls are used. I put braces on lingual in 20 minutes. Upper. Lower. Done. [01:04:05] Really? When my associates are coming, it’s two hours, so my girls go crazy. This. [01:04:10] Stefan. Why? Why is it two hours? Well, because they’re not me. I’ve done it long enough, but I’m at the stage. [01:04:15] I want to share my experience in anything. To make others think [01:04:20] differently, to do what they love, to do what they deserve to do. And when you get [01:04:25] messages from your students saying you changed my life, that makes me happy. And I helped the [01:04:30] kids. So, um, I love what I do, so. But I grow [01:04:35] only with word of mouth and it’s enough for me. Yes, [01:04:40] if I would have a running business with nine chairs and 2030 associates, I would have to do marketing. [01:04:45] But do I want that stress, or do I want to focus on getting [01:04:50] this mission out there, doing podcasts, doing training to get more help for [01:04:55] other people? Because I’m limited to maybe nine chairs, I can have a second business somewhere else, but that’s more headache [01:05:00] franchise thing, but I feel my mission, my [01:05:05] meaning now is to share it.

Payman Langroudi: Now this is what’s energising you. Yeah.

[TRANSITION]: Yeah, I love [01:05:10] it.

Steffen Decker: I love to make sure that people understand my why. My passion for [01:05:15] prevention now. I’ve done it all to help the children, to get them what [01:05:20] they deserve to do. And the that orthodontist. Because I believe [01:05:25] a lot of orthodontists are struggling. I know they’re struggling with getting patients NHS [01:05:30] contracts running out. They’re struggling to survive. [01:05:35] You might need to think about this. Be courage and have the courage to change. [01:05:40] Change is not comfortable. Sometimes it needs education. I’m here for you, [01:05:45] but I can share. I had to change. Why not change? You know, and [01:05:50] I think the year courses.

Payman Langroudi: How many days is it?

[TRANSITION]: Pardon?

Payman Langroudi: Ten days. Ten days?

Steffen Decker: No. My, [01:05:55] my one year course is 12 full days.

[TRANSITION]: 12 full days plus.

Steffen Decker: Mentoring plus exam. [01:06:00] And then I have what does it cost? £13,000 for one year.

Payman Langroudi: Do you [01:06:05] have to pay it in one go?

[TRANSITION]: No, no we do.

Steffen Decker: In instalments and we have orthodontic courses as well. And I would [01:06:10] love that more. Orthodontists are taking that opportunity to at least explore [01:06:15] this revenue of using this beautiful technology of clear aligners in kids, [01:06:20] and eventually make a different revenue stream for their business. And you [01:06:25] will see, I am completely private. The minute I stepped on UK soil it [01:06:30] was working. Yes, we for for phase one we’re charging about £3,000, [01:06:35] which is.

[TRANSITION]: Does phase one.

Payman Langroudi: Mean seven year olds?

[TRANSITION]: Seven year olds? [01:06:40]

Steffen Decker: So that is okay for most parents, especially if they can pay and so on. [01:06:45] That’s not a huge amount of money and they don’t need a lot of phase two. Generally [01:06:50] speaking, they might need to move some teeth, but we have enough space for the teeth. So [01:06:55] it is a lot of Benefit.

Payman Langroudi: Listen, man, you guys, I actually, when I took my son to the [01:07:00] orthodontist, I. Suddenly I felt so jealous of you guys, man, because [01:07:05] he he took a scan. He took a few photos, and then he started talking about [01:07:10] the face. Yeah. The minute he said face, I forgot I’m [01:07:15] a dentist, I forgot I know 100 orthodontists. I forgot all of that. And I was just like, take my money. Because, [01:07:20] you know the face when someone says your child’s face will be [01:07:25] like this or like that, or you’re going to just find the money for that, you know, it’s a beautiful thing [01:07:30] from a business perspective. I encourage, I encourage all orthodontists and dentists to mention [01:07:35] the face 100%.

[TRANSITION]: It’s emotional dentistry.

Steffen Decker: Christian Coachman talks all about [01:07:40] emotional. What more emotion do you want?

[TRANSITION]: Your child’s face.

Steffen Decker: You [01:07:45] change a kid’s smile. You change the way they live their life. You make them more healthy, better, breathing better. What? [01:07:50] What is more emotional than that? And the money you spend on that is so well spent [01:07:55] instead of late on, you go on social media. 25 years old, 30 years old. Can [01:08:00] cover ten teeth with bonding. Cost you £4,000, and two years later you do it [01:08:05] again, or five years later, or they start chipping away because it wasn’t done properly in the first place. So [01:08:10] what do you want? And you said that if you are good [01:08:15] in your diagnostic, you can create value. And what I always say [01:08:20] to my students, when you get emotion in the parents, you need to stop talking [01:08:25] because you have them. That is what you said to me. Match the face. Where [01:08:30] do I sign? This is the state where you have to say now it’s not about you anymore. To create value, [01:08:35] you have it. All they have to do is the mums. Go speak to the finance minister at home. [01:08:40] I bet the mum wants this, the child wants this. So the dad says sometimes [01:08:45] we have a zoom with the dad. But then I say it again, the same thing. This is your princess now this [01:08:50] can happen to your princess.

Payman Langroudi: And I think people are ignoring private child author [01:08:55] at their peril. Because, you know, if I mean these days you can target ads. [01:09:00] I know you’re not interested, but you can target ads to to a radius around [01:09:05] private schools. Yeah. And the ad can say, hey, mum, the NHS isn’t paying [01:09:10] for your orthodontist anymore. You know, some simple thing like that can start a whole child ortho, [01:09:15] private business. You know, I’m surprised more people aren’t doing.

[TRANSITION]: It’s. [01:09:20]

Steffen Decker: It’s surprised me as well. And when you teach and you see that they’re not [01:09:25] taking this opportunity, I think to myself, how can you not how can you not [01:09:30] see the bigger picture of what it does to the community, to yourself, [01:09:35] to your business, to the dynamics? It’s clear as [01:09:40] anything in front of me. And the beauty is now.

[TRANSITION]: What percentage.

Payman Langroudi: Of your business is referral [01:09:45] and what percentage is patient referral?

[TRANSITION]: Oh.

Steffen Decker: 95% [01:09:50] is patient word of mouth.

Payman Langroudi: Oh, really? Really? I’ve noticed that with some orthodontists. [01:09:55] You know, some orthodontists really manage well on that.

Steffen Decker: I like because I [01:10:00] create connection, I love it, I love passion, I love emotion, and I [01:10:05] have the backup of one of the best dentists in the world. John Cox is a big idol [01:10:10] to me. Like he knows everything under the sun, every research, he knows it and [01:10:15] that he has my back. It’s something which is so [01:10:20] valuable to me because it gives me strength. Confidence, courage, confidence. [01:10:25] And. And that he gave me the opportunity. And Christine, we together giving [01:10:30] this course at his centre in Seattle next year, which is the [01:10:35] first of a kind, shows us we’re doing the right thing and this [01:10:40] is eventually the way forward. And my mission is to do that more and more and to spread the word. [01:10:45] So this gives me the strength also to fight eventually some people who might [01:10:50] want to attack me because they feel threatened. I don’t know what the reason is, but my core intention [01:10:55] is out of love and to help. So I don’t want to fight any orthodontist. I don’t want to fight any [01:11:00] dentist. Everyone has the right thing. But let’s work together in this relationship.

Payman Langroudi: It’s the nature of our [01:11:05] profession. Ego. Ego is a big. I’ve noticed orthodontic egos are even bigger than. Absolutely. [01:11:10] On this part, we like to talk about mistakes. Have [01:11:15] you. Have you heard of Black Box thinking? No. So it’s a book about airline crashes? [01:11:20] Yeah. And what happens when a plane crashes? They look at the black box, and then they [01:11:25] find out what went wrong and immediately tell the whole pilot community what went wrong [01:11:30] without blame. Blame isn’t the main point of it, is to try and stop it happening [01:11:35] again. And then it sort of segues into medical. When something goes wrong, [01:11:40] let’s say something bad. Someone dies. Yeah. It comes, first of all, to whose fault was [01:11:45] it? And blame. And in medical. We’re encouraged in a way, because of the system [01:11:50] to hide our mistakes. And then by by its very nature, then we don’t all learn [01:11:55] from each other’s mistakes. So on this pod, we like to say, go against that. What [01:12:00] would you what comes to mind when I say clinical mistake that you made?

Steffen Decker: Or I [01:12:05] made so many mistakes, but I’m a guy. I take a picture [01:12:10] of the mistake, think about it and teach about it. What [01:12:15] you should do different, try a different approach. Maybe that helps and share it.

[TRANSITION]: Because [01:12:20] what was one that.

Payman Langroudi: Was almost like an aha moment for you?

Steffen Decker: The aha moment, [01:12:25] um, was meeting my wife.

[TRANSITION]: The mistake. I know that [01:12:30] was.

Steffen Decker: The best decision.

[TRANSITION]: Of my life, but I think in this.

Steffen Decker: Static university [01:12:35] thinking anger class one, I need to move in this perfect. [01:12:40]

[TRANSITION]: Bite. The functional.

Payman Langroudi: Occlusion.

[TRANSITION]: Part that to.

Steffen Decker: Miss this function, the dynamic makes [01:12:45] so much sense that we are much more complex than just. That’s not how we do work. [01:12:50] So this was.

Payman Langroudi: Just tell me about the mistake then.

Steffen Decker: Well, I extracted [01:12:55] teeth. I didn’t need to extract teeth. Yeah, I moved, I tried [01:13:00] to push back with mini screws. Everything plus one. And they failed. Eventually. Later. [01:13:05] Which I might not even know because they never came and see me. And there’s no relationship that I [01:13:10] might have made some kids sleep worse by, [01:13:15] for example, when they have big space because there’s a big tongue thrust [01:13:20] and I move everything back and their tongue is, where’s it going? So that I could [01:13:25] have had an impact in their health. Um, that makes me emotional. And [01:13:30] of course, I shave. Maybe too many teeth. Yeah, destructive. So [01:13:35] a lot of things I know now, I would do completely different nowadays, but [01:13:40] I.

[TRANSITION]: Can kind of.

Payman Langroudi: Not going to let you get away with that, you know.

[TRANSITION]: Because mistake.

Payman Langroudi: That’s the other class that as a mistake, [01:13:45] you know that what you knew at the time. I’m talking about a mistake. Another way you can look at it. I [01:13:50] don’t like the. I dropped something down the page. Yeah. Another way you can look at it. Who is your most difficult [01:13:55] patient?

[TRANSITION]: Um.

Steffen Decker: Psychology. Yeah. [01:14:00] Like, I really struggle, um, when [01:14:05] when I get emotionally attacked by patients who might not be happy [01:14:10] with themselves and they see the problem in the Dental work I [01:14:15] might have done, and I can’t understand because my first intention, [01:14:20] every intention of evidence is to do the best. Yeah. And if you have this criticise [01:14:25] on your work, it hurts and it hurts. And because you try and you try your [01:14:30] very best and I just, I literally can’t handle this emotion. [01:14:35] And there were times where I literally just did my job and I ignored it. [01:14:40] I turned my back on that patient which caused the complaint not [01:14:45] because of the clinical work, but because a patient felt I didn’t talk enough. [01:14:50] Yeah. So I the mistake is that even [01:14:55] so, some patients are not on our wavelength. We have to give them the time, [01:15:00] the dedication, the attention they deserve. Because if you would take [01:15:05] time to get to know them a bit more, there’s much more behind that facade which [01:15:10] impacts their life. And I know that now, more and more with airway, [01:15:15] they might really struggle to sleep, which has impact on their mental health, which impacts their behaviour. Brilliant. [01:15:20]

Payman Langroudi: Brilliant lesson. It’s a brilliant lesson because you know that the chairside manner of a dentist [01:15:25] is not only important in not getting sued. Yeah, that’s [01:15:30] a sort of a fear thing. It’s important in understanding that patient’s goals [01:15:35] and habits and compliance and everything that you just said. I mean, you know, you said [01:15:40] to me, based on the social situation of the patient, you may switch from [01:15:45] lingual to aligner. And they’re totally different treatments, right?

[TRANSITION]: 100%.

Payman Langroudi: So the [01:15:50] chairside manner, I don’t think we enough of us have understand. [01:15:55]

[TRANSITION]: How.

Payman Langroudi: Important that is.

Steffen Decker: The most time of my treatments is on a consultation, because [01:16:00] I need to get to know this individual.

[TRANSITION]: Lingual in.

Payman Langroudi: 20 minutes. Right?

[TRANSITION]: Right. So and [01:16:05] and.

Steffen Decker: What’s happening there now with the social marketing to a tick box. [01:16:10] Then we know what you need. You come in in a box, you get a scan, you get a liner sent home. [01:16:15] Where’s your patient communication in this. And now [01:16:20] I see it again the value of it. Because you get to know [01:16:25] an individual with all the different facets of life of business they’re doing, the [01:16:30] struggles they’re having you connect in an emotional basis. And what will be the biggest [01:16:35] problems for our children with a virtual reality world? The connection.

[TRANSITION]: By the.

Payman Langroudi: Way, I [01:16:40] stopped practising 1213 years ago and that is the bit I missed the most.

[TRANSITION]: By.

Steffen Decker: Interaction. [01:16:45] It’s. And this is why I love to teach now because I get this interaction [01:16:50] again and we did the professor. So if we go more into technology and [01:16:55] AI, we lose the the touch to the human being [01:17:00] and our kids. I see with my own eyes now my kids talking to a virtual person [01:17:05] on an app. Wow. Where is reality? Vr glasses? Where is this all going? When [01:17:10] they’re walking around in these glasses, this personal touch mannerism. [01:17:15] Take the time. And yes, there might be scenarios where you think you [01:17:20] don’t align and that’s fair enough. Nobody needs to align. But take [01:17:25] the time to invest in your patients and then you make a decision together. And this is what [01:17:30] I do now. Everything we do I learned from these mistakes, I will communicate. [01:17:35] Says I’m not a magician. That might go wrong. This can go wrong if it goes wrong. This is the [01:17:40] next solution and we have a nice relationship all the way through. And that gives you nice feedback. [01:17:45] And so I think because but that was also for my private experience [01:17:50] and my past relationships, is when I’ve seen a crazy person in [01:17:55] my mind, I stepped away, I was running away. But sometimes you need to face it [01:18:00] and change your manners and how to deal with it because it makes you a bigger, stronger [01:18:05] person as a clinician as well. So I think this is one of the main mistakes, is my communication, [01:18:10] taking the time to get to know this individual what they want. And with [01:18:15] kids, it’s absolutely the same stuff.

Payman Langroudi: Where does it go back to this sort of [01:18:20] high achieving, always curious, [01:18:25] uh, passionate sort of where what are the origins of [01:18:30] that?

[TRANSITION]: I mean, me.

Steffen Decker: As a person, I wear my heart on my sleeves like I am emotional, [01:18:35] I love helping, I did neighbourhood help. My whole life I was caring [01:18:40] for elderly people, taking care of the gardens, the dogs, whatever they had. I love [01:18:45] helping people and the interesting bit of my wildlife is next to me. In my mom’s [01:18:50] house there is a children’s psychiatrist. She knows me since I’m a kid. Really? And [01:18:55] when it came to A-levels, I didn’t know what to study. I was always good at school. She said to me, Stefan, you [01:19:00] need to do either medicine to help or to teacher to teach. [01:19:05] Now I do both. And, um, [01:19:10] I am always. The thing is, I’m a very logical. My father is a [01:19:15] informatics. My brother is a physicist. Professor. So very logic mindset in [01:19:20] the family. We talk about physics on the dinner table in Christmas. Boring for me, but that’s the way [01:19:25] it is. So I’m a very logical guy. So it means if someone tells me something, I try to [01:19:30] see their point and if it makes sense in my head. And that is what [01:19:35] helps me now to link all of these problems together. So okay, he says this. He says [01:19:40] where could be the cross link. And to be open. And when you do neighbourhood help, [01:19:45] you are open to different needs to different personalities because you [01:19:50] deal with a lot of elderly. They tell you a story about World War two and then you deal with other people. [01:19:55] They tell you a different story. But that’s for me, very interesting. So I had always had a passion for people [01:20:00] and had always the passion to know about their stories.

Steffen Decker: And I tell [01:20:05] stories all the time. And because my academic background is physics, so [01:20:10] orthodontics is easy physics. So, um, and I get [01:20:15] bored super quickly. So 2017 was lingual. I [01:20:20] wanted to become the best in what I do in adult market. I did it then five [01:20:25] years ago. I wanted to be best in kids in aligners, I did it. What’s [01:20:30] now now is it’s John Kois education and this whole messaging, and [01:20:35] I want to be good in it and spread the word. And I want to think maybe the [01:20:40] next few years teach and create, change somebody’s mind. Dentist, orthodontics, [01:20:45] paediatrics, and God knows what I do when I’m 50. I don’t know, maybe do a different [01:20:50] business because I’m generally interested in I have so many pages with different businesses and I [01:20:55] go out for dinner with them. It’s interesting to me. I am not the guy who can stick around in [01:21:00] one thing for a long time. I get bored too easily, which is to the detriment of my [01:21:05] wife because I’m running all the time. I get ideas every week and [01:21:10] my wife sometimes says to me, you’re too quick in going forward. We need to get this established [01:21:15] first, because if we don’t have this established, the other one will not work neither. So it’s nice to have someone [01:21:20] by your side who says to you, why slow down? Yeah, let’s get this right first, [01:21:25] and then we go to the next step.

[TRANSITION]: Keeps your feet.

Payman Langroudi: On the floor while your.

[TRANSITION]: Head’s in. It’s super important. [01:21:30]

Payman Langroudi: In the sky.

[TRANSITION]: Yeah. Your kids.

Steffen Decker: You know, for your kids, your dad, my my [01:21:35] kids said to me the other day, oh, you see, quite famous people said, yeah, I [01:21:40] didn’t have any idea what you do because for your kids you’re dead. You want to play, dedicate time [01:21:45] with your kids and play with them. And my kids are my biggest supporter. Like when [01:21:50] kids ask my kids, why do you have a license? Or my daddy is the best, they don’t even know what they are my best [01:21:55] in. But for them, I’m their hero. And that’s from a father point [01:22:00] of view. My dad was my idol. He did a lot for me and [01:22:05] I want to be that for my children. And, um, I just have so [01:22:10] much in me and passion and I think now [01:22:15] it’s the time for me to share this and my time to shine, [01:22:20] to share this passion and to make other people become better in what they do if [01:22:25] they want to do that. So that is what I feel now. That’s why I also [01:22:30] came to you. Because I want this so hard to share this passion [01:22:35] for orthodontics again. And as an orthodontist, [01:22:40] please listen to at least be open for new things. And this [01:22:45] is about working nicely together and kids is for me a blessing. Treating kids now and [01:22:50] adults is for me now is just for fun. I do it because I still my root. My [01:22:55] main reputation a few years back was lingual. I became a big name in the world. [01:23:00] Now it’s something different. In five years there might be a good educator. Let’s [01:23:05] see what’s happening.

Payman Langroudi: And can you give me I mean, it sounds like John’s become one of your mentors [01:23:10] now, but a list of a couple of mentors that sort of changed [01:23:15] the way you thought about privately.

[TRANSITION]: My wife.

Steffen Decker: Like she did [01:23:20] a lot of Tony Robbins live coaching before I met her. So when I met her [01:23:25] as a as a private person, she was the best version of herself. Happy with [01:23:30] herself. And she helped me enormously through my struggle, my life and guide me into [01:23:35] emotion. How to handle it, how to handle my private struggles. So [01:23:40] my wife definitely. Then professionally. John. Yeah, he [01:23:45] inspires me. He supports me. Um, then my kids, [01:23:50] my friends. Like, I really got to understand the importance of friends, [01:23:55] good friends in your life.

[TRANSITION]: But other.

Payman Langroudi: Mentors in orthodontics.

Steffen Decker: In [01:24:00] orthodontics.

Payman Langroudi: Courses you went on or.

[TRANSITION]: I like, obviously.

Steffen Decker: Um, Giuseppe [01:24:05] Guzzo, he’s one of the main lingual persons in Rome. He developed several [01:24:10] systems. He’s one of my biggest friends. Then Benedict Willems in Dusseldorf. He’s the [01:24:15] skeletal Anchorage guy. I work with him in 2008. Then there’s [01:24:20] Ben Lopatka University of Ulm. He does a lot about lip pressure and function [01:24:25] occlusion by Professor Jonas at Freiburg University. Because she was teaching me about lips [01:24:30] and tongue and breathing already dead back then and for my education point of view, [01:24:35] my boss in Germany, in your speciality training, you are allowed to do two years [01:24:40] in private practice and one year in hospital. So I had the luxury of [01:24:45] spending two years in a private practice, and my boss at that time didn’t pay me [01:24:50] a lot of wage, but she sent me on every course to enrich [01:24:55] my skill set. And at that time, I was 25. I didn’t understand what she’s [01:25:00] doing, but very quickly I was running her business because I could do lingual, I could do [01:25:05] skeletal, and I did buccal. Everywhere. She sent me to us, to England on her [01:25:10] costs. She paid everything for me.

[TRANSITION]: Well done.

Steffen Decker: And I was only 25. And my dad always [01:25:15] used to say to me, you have to invest in yourself first, and the money will come [01:25:20] later on in your career. So that she had to believe in me at that time [01:25:25] of my career was now hindsight for me. Wow. Because [01:25:30] I would be doing the same now. If I have an associate now and believe in, I would [01:25:35] do the same. Because eventually this can be your left hand who is running your business [01:25:40] for you and you can do other things. So as a business owner now together with [01:25:45] my wife is we invest in our stuff. So we send them to courses because we want [01:25:50] them to be happy, to be the best version of themselves. And ultimately it helps the business as well. [01:25:55] Whereas a lot of other clinics I worked in, they didn’t do that. They didn’t care if their nurses [01:26:00] are doing this or this. So they never progressed as a business. So [01:26:05] because I had the luxury of having this mentors in my life and people privately [01:26:10] who helped me in my life, I want to give back. So if I have orthodontists [01:26:15] who struggle, I will hold out my hand, says, I can help you. I can connect you with clinics [01:26:20] If I have people who want professional help, I’m here to help. I love students. [01:26:25] Text me every day and I help them. I think when you have met these certain [01:26:30] people in your life, you want to give back the same feeling. And [01:26:35] because I think that’s how we should work together and behave, [01:26:40] that’s me. So I have a few people in my life, but obviously the biggest is [01:26:45] my dad.

[TRANSITION]: Oh.

Steffen Decker: Because he gave me everything. [01:26:50]

Payman Langroudi: Is he still with us?

[TRANSITION]: No. I’m sorry.

Steffen Decker: So he unfortunately passed away [01:26:55] in the hardest time of my life, but he sees my [01:27:00] success. So he was my biggest idol.

Payman Langroudi: Let’s [01:27:05] get to the final questions. Yeah.

[TRANSITION]: Sorry.

Payman Langroudi: That’s all right. Fantasy [01:27:10] dinner party. Three guests. Dead or alive. [01:27:15]

[TRANSITION]: Dead or alive. Um.

Steffen Decker: Um, [01:27:20] Giuseppe Guzzo, my dear friend [01:27:25] and mentor. Um. Maybe [01:27:30] the Backstreet Boys.

Payman Langroudi: Well, [01:27:35] there was one guest as the entertainment at the dinner party. It’s just.

[TRANSITION]: I. [01:27:40]

Steffen Decker: Used to love them, and I was singing a lot of nice memories about that. And, um. [01:27:45] And who else is [01:27:50] going to be good? And probably my best friend Dean for action. Part of things. [01:27:55] That would be a nice dinner and just a nice chat. [01:28:00]

[TRANSITION]: Excellent.

Payman Langroudi: And the final question is a deathbed [01:28:05] question. If you’re on your deathbed surrounded by [01:28:10] loved ones. Um, by that time, it would be the great grandchildren or whatever [01:28:15] it is. You have to give them three pieces of advice. What would they be?

[TRANSITION]: What [01:28:20] would it.

Steffen Decker: Be? Um. Love with your heart. Um. [01:28:25] Treat everyone with respect and try [01:28:30] your hardest. Whatever you can achieve. If my kids do [01:28:35] that, I’m happy. Yeah. Have respect. [01:28:40] Try your hardest and love with your heart. And surround yourself with people [01:28:45] who are good for you. And that’s the hardest bit, I [01:28:50] think.

Payman Langroudi: Stefan Decker.

Payman Langroudi: It’s been a massive, massive honour to have you. [01:28:55] Thank you so much for coming.

Steffen Decker: Thank you for this time and to give me the opportunity to share [01:29:00] my passion. I hope I can.

Payman Langroudi: Best way to get to you.

Steffen Decker: Gateway is the [01:29:05] orthodontic specialist. It’s my Instagram account or the orthodontic specialist academy. [01:29:10] But just text me on Instagram. I’m available. Yeah, it’s someone is in charge [01:29:15] of that, but I’m always there to help. So if you reach out for the courses, it’s also the website [01:29:20] the Orthodontic Specialists UK in the course section, but just follow me on Instagram [01:29:25] and whatever I do and hopefully I meet you all one day. Thanks a lot. [01:29:30]

[VOICE]: This is Dental Leaders the [01:29:35] podcast where you get to go one on one with emerging leaders in dentistry. [01:29:40] Your hosts Payman Langroudi [01:29:45] and Prav Solanki.

Prav Solanki: Thanks for listening guys. If you got this far, [01:29:50] you must have listened to the whole thing. And just a huge thank you both from me and pay for actually [01:29:55] sticking through and listening to what we had to say and what our guest has had to say, because I’m [01:30:00] assuming you got some value out of it.

Payman Langroudi: If you did get some value out of it, think about subscribing. [01:30:05] And if you would share this with a friend who you think might get some value out of it [01:30:10] too. Thank you so so, so much for listening. Thanks.

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