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

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

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

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

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

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

Where did you grow up?

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

And you went to university in Bristol, right?

That’s right, yeah. Yeah. Bristol.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Oh, really?

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

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

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

For myself.

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

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

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

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

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

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

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

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

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

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

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

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

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

No, not really.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Mhm.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

So zygomatic pterygoids.

Mean, zygomatic. Do you do all that?

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

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

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

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

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

Behind.

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

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

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

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

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

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

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

Yeah, I remember saying something like that.

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

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

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

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

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

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

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

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

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

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

Yeah, 20 odd years ago.

So, yeah.

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

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

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

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

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

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

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

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

Nothing actually went wrong there.

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

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

So, I mean.

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

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

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

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

Oh my God.

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

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

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

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

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

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

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

Yeah, Yeah.

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

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

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

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

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

So. Okay. What else comes to mind?

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

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

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

What else. What else. What other high points.

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

Is it really? Wow. Yeah.

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

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

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

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

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

Zoned into it.

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

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

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

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

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

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

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

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

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

Mm That’s nice.

And that’s kind of the philosophy.

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

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

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

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

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

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

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

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

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

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

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

No, not necessarily.

Leadership, is it?

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

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

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

He is not very long, is it?

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

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

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

Yeah, yeah, yeah.

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

And he’s been very good at that.

Yeah, absolutely.

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

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

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

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

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

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

Just.

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

It’s a living legends.

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

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

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

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

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

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

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

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

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

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

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

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

What’s your favourite book by William Boyd?

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

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

Yeah.

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

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

Throw out some names of those people. Clinical heroes.

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

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

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

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

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

How old are your kids?

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

Budding dentists out there.

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

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

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

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

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

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

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

Both of our faults.

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

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

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

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

And don’t forget our six star ratings.