It’s scary. It’s really scary. From the financial perspective. I think that that was probably the scariest because I was sitting and earning money and then putting it straight into this. And.

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.

Regular listeners to the port will remember episode 113 when we interviewed the Dental sisters, Ariana and Victoria Samson, and the last time I spoke to them, they were both associates working in lots of different practices, and now I’ve come to visit their brand new practice in Mayfair, which is called the Health Society. Something different, and I wanted to catch up, see what the process was. You know how the trials and tribulations of opening a practice in Mayfair are. So I’ve got for now, I’ve got Victoria with me. How are you? Hello.

Hi. I’m good, thank you. Yeah.

It’s a beautiful practice. Thank you. I must have been to a thousand practices. Right. So I’ve seen a lot of different practices, and it’s really different. Colourful. Quite pink.

It’s a little bit. A little bit.

Pink, but a lot of art on the walls. And you can tell that, you know, it’s almost like you guys have been thinking about this for a long time. If you if you think about it, when, when, when did you know you were going to open your own practice from the get go, or when did the idea start?

I think for me, to be completely honest with you, it was quite late on. So my sister and my mom and kind of everyone else I think had this idea, we’re going to open this dental practice and they had all of these ideas, but for me, it was probably only in the last kind of year or two years that I thought, okay, yeah, this is happening. We’re opening our own clinic and it’s now I kind of thought always that I would open it maybe in 5 to 10 years time, to be honest with you, but then with, you know, everyone else wanting to open it and then also all of my patients pushing me kind of just meant that I went with kind of what everyone else said. And I’m I’m glad that we did it. But I think that patients really pushed and they really were like, you’re doing something very unique and special, and it’s a shame that you are not in your own clinic and you don’t have your own clinical freedom to do whatever you like. You should open your own place and just do whatever you like. So, yeah.

And so look, the process, a lot of dentists are going to go through this process of being an associate and moving to becoming a principal. How much of it did you already know and how much of it did you have to go and find out? And what about the the financial side, you know, getting loans and and saving up and all of that sort of thing. So talk me through that part of it. The pre pre starting anything pre even looking for for a site.

I think know as a dental student you’re taught to be a dentist. And the financial side the even opening a clinic the management all of that is not anything that you’re taught at university or even as an associate. So we had a tough time kind of having to learn all of that. And there’s also not like a manual or a person that you can just call up and ask, you know, for example, it’s not like you can just call them up and be like, hey, could you just help me a little bit and tell me, you know, what colour bin I should get? Or, you know, like it’s very difficult. Yeah. We were super lucky that we had a lot of amazing people to support us who are already practice owners. So they kind of would help us in terms of, okay, yeah, you need this water filtration system or, you know, you know, in your decon room you should have x, y, z. And that really helped. So I think having great mentors to support you is key and extremely important from the financial side of things. So originally we were going to get a loan and we were going to kind of do it the I guess traditional way, but it ended up that we were trying to get a loan out at probably the worst time imaginable, with everything to do with the pandemic and Covid and, you know, the housing crisis and then the living costs crisis and all of this, that our interest rate was just ridiculous. It was it was yeah. It wouldn’t have made sense to open a clinic. So we ended up actually just using all our savings up and just really it was completely self paid for. And I think that is a testament to how much we thought, like how much we wanted it and the risk that we put in, because everyone has always said, when you open your own business, you should never use all of your own money. But we were like, look, it’s either that or, you know, a 20% interest rate, which we’re not going to do. So yeah.

But that’s a hard thing to do, right? Because if you’re the kind of person who, you know, works diligently and saves diligently and then and then, you know, that sort of nest, nest egg, it’s kind of like a buffer that for a rainy day, and then you’ve gone and spent the whole lot. On a dental practice. Were you scared?

I think you know what? I wasn’t scared for a really long time. Throughout the whole construction side of things, I was. And I think I was in a bit of fight or flight mode of just, like getting it done. Getting it done. I didn’t care. And then it hit me quite late on like a month or two before we were opening, where I was like, oh my God, like, what if no one comes? Yeah, shit. Like, what happens if, you know, we can’t hire any staff? And what happens if no patient ever wants to come and see us or okay, they come for their first appointment, but they don’t come for their, you know, six month check-up because they didn’t like the service that they received. And that’s where I think I was terrified. But I think that when you have a goal and you know that what you’re doing is special and different and that you’re bringing something new to the market and you really believe in it, then that fear is kind of secondary. Like it’s kind of, okay, fine, you will be scared. I think for me in particular, because I’m quite young, I kind of I see a lot of my friends and I see a lot of other people who are maybe my age and they’re using their money to go on holiday and they are travelling and they’re, you know, buying a car and they’re, you know, and so it was weird for me to put that money away into something more substantial and open a business with it. No regrets, but it was just a bit of a different did you need someone.

To push you over an edge? Did someone have to say, hey, look, go for it.

Yeah. My mom. Yes. And my.

Sister.

And like I said, all my patients, they just kept on saying it and saying it. And that’s also what gave me that safety net of saying, okay, like if we open a clinic, I have at least, you know, 100 patients who are going to follow me. Social media helped as well. And I knew that, okay, our concept is unique.

And, you know, you told me that you don’t you didn’t use the traditional dental fitout. People did that come with its own problems because they didn’t understand, you know, suction and all of that.

Yeah.

So why didn’t you use traditional dental? Because you didn’t want it to look like a traditional dental practice?

Partly, yes. Because also. So when we were we originally did approach lots of traditional dental fitout companies, and the designs that they were creating for us were pretty much, you know, copy and paste of the other 20 clinics that we’d visited. And we wanted something completely unique and different. That was one problem. The second problem was that we found that it was very expensive. And for a completely self-funded project with no investment, we quite honestly didn’t want to spend that much money. And we were there were a lot of times where we still continued with with a company, but it was just getting a bit ridiculous where we felt like we weren’t getting value, value for our money. Every time we would make a change, it would be an extra couple of thousand pounds on our bill, and it got to a point where we were like, we have no freedom.

So we started out with a traditional company and then changed.

And then we changed and we decided, actually, you know what? Let’s get some prices from some just normal construction teams, builders. And it was, you know, a fraction of the price. We had a lot more freedom. I work with a lot of companies like as a, you know, advisor or ambassador or whatever. They were super supportive. And so we ended up just kind of creating our own relationships with companies. We were our own project managers. So we never had.

A were you here every.

Day, every day before work. And I was still working full time. So before work I was here 7 a.m. I would go to work for nine, then I would come during my lunch time, and then I would come after work as well. And we were between the three of us. There was always someone on site, but we were, yeah, we were going crazy like we were working ridiculous hours.

Have you ever project managed any building work of any type? No. House? Nothing?

No no.

No, literally this is the first we’ve.

Ever done. Yeah. So we and we what surprised you the most? Um, it was actually phenomenal to see what’s behind walls. And I was obsessed with plumbing. I thought the plumbing was mind blowing and so interesting. So I got really into that. Um, I think that also just how many different jobs and things need to be done, particularly for dental practice, because the construction team that we chose, they had never plumbed for a dental practice. So we had to, you know, use like we had to kind of help with them and we had to kind of decide on things together. And it worked out. But I mean, it could have gone terribly wrong, probably.

And the logo is everywhere. Yes. And I like that, you know, that’s what that’s the whole point of a logo is that that’s what. But you’ve done a really special thing that I’ve never seen before, where you’ve actually recessed the logo in lighting on the ceiling. Yeah. Whose idea was that?

It was mine, actually. So it was with my. So one of my kind of mentors or the people who helped us with this practice is my boss from one of my other practices. And I went up to him straight up and I said, look, I want to open my own. He was like, yeah, I mean, it’s about time. I thought you were going to open it last year anyway. So he was super supportive and he helped a lot because his was a squat practice and he together we decided that what would be really cool is to have the logo in the ceiling recessed with LED strip lights. And so we actually measured the wattage, the Kelvin, because there’s a specific amount of lighting that a dentist or any, you know. Um.

But my question is, look, it’s a straight line logo. Yeah. So did you get a bunch of straight line LEDs and put them together? Or if it was a round, curvy thing, you would you could have done it too.

No. We got so this is the first time in my life I ever used Pythagoras finally came in, finally came in to use one of my builders. And I were sitting there and I was like a squared plus b squared equals c squared three.

Four, five.

So it’s lots of lots of straight lines that we combine together. And we just cut loads of LED strips up and put them together. So God forbid we ever have to replace those lights. That’s a whole other issue.

And the name the Health Society and now visiting it, I kind of understand it a bit more because there’s a gym area, there’s a sauna, infrared sauna area, but also your work. And we discussed this on the on the previous episode is a lot to do with functional dentistry. The whole body sort of holistically looking at, you know, systemic disease and the effect of that on the mouth and vice versa, which is a really interesting part of it. And you showed me just now a machine that sort of gives you a score of collagen breakdown and that kind of tells you how active is gum disease. Yeah. You think, shouldn’t every single dental practice have that machine? I mean, it really is a really important machine to have, isn’t it? If you can give a score, how accurate is it? You know.

It’s extremely accurate. So yeah. So we have lots of different tests that we do here. So we do one which measures your collagen breakdown to assess your basically gum disease from a bio molecular level. So we know that often gum disease is happening six months before clinical symptoms are appear in the mouth. So this is finding that and being able to flag that patient before they start getting, you know, pocketing and bone loss and being able to say, okay, let’s reverse this before it becomes a problem. And it’s as.

Simple as like a little mouth rinse and spit into the thing and put it in the machine.

So now what’s the name of that machine? So it’s for Ampa is the enzyme and the we just call it the Ampa test. So the enzyme is activated matrix metalloproteinase eight. And it’s the enzyme that is for collagen breakdown. And then we do the bacteria testing. We look at your saliva pH as well.

What does that involve.

Saliva test as well. So it’s a spit test. And then we send it off to the lab. And then we look at all of the bacteria in your saliva and fungi as well. So we can see if you have any candidal infections. And then based on that, usually in combination with the other saliva tests that we do, we create a personalised oral hygiene plan. So it will tell you exactly what mouthwash is good for your microbiome. What toothpaste? Toothbrush. If you have gum disease, what is causing that gum disease? Which bacteria? So then if we need to give you antibiotics which ones. So it’s a lot more specific and personalised for the patient. But also but.

Explain it to me. You get back a list of bacteria names and how much of it there is in the mouth. And so I guess the gram negative ones are the ones causing the problem. So when you say you bespoke the antimicrobial to that, how do you do that? How does that work?

So it depends on not only which bacteria are present, but how you know, the patterns and the amount of bacteria as well as what is visible clinically because everyone’s microbiomes are slightly different. So what might be terrible in my mouth might be really good in your mouth. Oh, really? Yeah. So you really have to pair everything together even. It’s not just, you know, gram negative, gram positive or anaerobic aerobic. There’s a lot more that you can, you know, you can use for those bacteria. So it could be that we use specific sprays. Gels again mouthwashes I love mouthwashes a lot actually for what we really take pride in is we’ve got a fantastic recovery for full mouth disinfection and periodontal patients. So patients who are suffering from really bad perio by having more of a focussed approach and knowing exactly what’s causing their their periodontal disease, then we’re able to actually treat it properly and we’ve had fantastic results using that. And we can measure and monitor that with the collagen breakdown test. So it’s it’s not only solving the problem, but it’s monitoring and maintaining that patient, which is really the core of our practice.

And just give us an idea because this is so new that. People want to know what’s the cost to the patient of each of those? The collagen tests. The the microbiome tests.

So at the moment, we’re actually the hygienist. I’m trying to push the hygienist to do a lot of the testing. And so if it’s about £2,025 for a collagen breakdown test, the oral microbiome test by itself is £250 that we charge. But that doesn’t include the analysis. And then it depends on what treatments are needed. You know, if you need full mouth disinfection, if you need, I don’t know. Whatever it is. I would like to think that I’m trying to find a price point which is affordable to a lot of patients. And yes, you know, I’m not saying it’s cheap, but at the end of the day, the amount of time that I spend on creating those treatment plans, each patient is probably 40 minutes to an hour of additional planning for that person that we do charge for it, because the benefits that we’re seeing are superior.

I’ll tell you the truth, it’s actually cheaper than I thought it would be. Yeah, but I’m interested in this. Have you ever done a microbiome test scan and polish and another microbiome test? Yeah.

So we did so weirdly. So we did a study or a trial with EMS. I partnered with them and we did an oral microbiome test immediately before a hygiene, immediately after a hygiene three months later, immediately before and then immediately after as well. And we used their, their hygiene. So we use guided biofilm therapy. And what we found was that immediately after a hygiene, the oral bacteria was extremely elevated. And that’s because you basically spat it all out into a cup. But interestingly, with the guided biofilm therapy, because it uses it’s got an antibacterial component to it. So it uses erythritol. The erythritol was able to reduce the levels of the bad bacteria in the oral microbiome, not only short term but also long term as well.

So just for someone who doesn’t know what is guided biofilm therapy.

So it is a treatment that a company called EMS from Switzerland have created. It’s their solution for a hygiene treatment. So basically what you do is you use a plaque disclosing tablet, you paint the teeth with it, and that will show all of the areas of biofilm and plaque. And that guides you to removing the biofilm properly because, you know, most of the time we’re not actually removing a lot of the biofilm when we’re doing a hygiene with a normal ultrasonic or with a pzm. So this has like an air flow. So it’s like a proper spray. And that spray has been impregnated with erythritol, which is antibacterial. So that gets rid of all your biofilm, all the bacteria and your staining without damaging the teeth. And then we go over and around the teeth again with the PS on to remove any hard capulus or tartar. And it’s with warm water and it’s got like a no pain technology. So it really is a fantastic solution. It really is, in my opinion, a better alternative to a normal hydrogen treatment.

And so is that GPT is that marketed like that at dentists or do you market that at patients as well?

I think we’re in a bit of a unique situation where a lot of our patients are extremely tuned in, and they come to us knowing that they are going to get that kind of personalised and maybe heightened kind of treatment plan. Yeah. The elevated treatment. Yeah. So we do paint it out to them as saying, okay, this is going to reduce your bacterial load. This is going to be no pain technology. You know they’re very educated patients as you mention it specifically. Yeah. And they specifically come here because of that for EMS with general dentistry, I think their main angle is that it is a lot more comfortable. It’s a lot more effective for the dentist. To the hygienist, it’s much less pressure on their wrists and their hands. So if you’re a hygienist and you’re working, you know, back to back 12 hours a day, you can’t use a poison or an ultrasonic constantly because the vibrations can really hurt you. So the airflow really helps. But yeah, there’s more comfort. Our angle is more maybe science and improving outcomes.

So I know you have to go. You’ve got a patient waiting. But let me just finish off with a couple of other questions. What’s the Mayfair patient like compared to I mean, you’ve worked in Harley Street and and and other places, right? Yeah. What’s what’s this patient like. Are they are they more picky? Are they more, you know, do they miss appointments or do they what are they like. No.

So, you know, the thing is, is although we’re in Mayfair, a lot of our patients travel from all around, actually the world. I had a patient from Chicago last week, another one from Berlin from LA. Like they actually are flying in for treatment. And so it’s difficult to say what the. Mayfair patient is like. But from the few who do share the same postcode as us. Because I do analyse being like, oh, you’re a resident, you’re cool.

We all do. We all like.

How exciting, you’re local. They are actually very. They are on time. They don’t miss their appointments.

Because they’re abroad a.

Lot. They are abroad a lot. That’s one thing, is that a lot of them will mean booking appointments for them is quite complicated. It’s not so easy. And a lot of because they travel and all that, but generally they’re pretty switched on patients. I think the patients we generally are attracting are ones who are into optimising their health. And as a result, sometimes you can get some patients who are quite difficult because they think they know better than you, or they’re a little bit more kind of, you know, take out all my root canal treated tea, take out all of my implants, you know, and you can go down quite a rabbit hole of very kind of aggressive or excessive dentistry. But generally I think we we’re doing a good job in, in kind of attracting the right types of patients that we want.

What do you do in that situation? Just somehow not do it? Yeah.

Yeah. I think that I’m. It’s annoying because I think I’m maybe more holistic or functional than your conventional dentist. You know, I believe that mouth is really connected to the rest of your body and all of that. But, you know, I still do root canals. I still believe in titanium implants. I’m still very much a normal dentist. And so what I really try is to convince those patients and explain to them the research. And I’m very research heavy, so I will explain all of it. And if they still decide, you know, actually I really want all my root canal treated teeth to be taken out. And they’ve had a cbct, for example, and there’s a sign of an infection. Fine. We can take it out if there’s no sign of an infection. And they’re still really, really want to have the teeth taken out, then I tell them to go somewhere else because it’s not worth it’s not worth my stress, really. And, you know, we all have our morals and our beliefs. And I’m not going to, you know, change them because compromise them. No. Yeah.

You’re also a DJ.

Yes.

And you were just telling me how you take control of the music in the whole practice. Yes. Is there going to be an element of a DJ deck and actually literally playing decks? Yes. I can totally see it happening in front.

Of the light.

Yeah, yeah, the pink light.

Yeah, yeah, I want to. I’ve actually had quite an idea I haven’t come I haven’t done much about the idea, but I want to do like a boiler room set in front of the light invite, like, you know, 20 people, not too big. Do like an hour and a half set. Film it. And for all of you who don’t know what a Boiler Room set is, it’s basically like a DJ set. And usually they’re in quite interesting locations. Yeah. And you invite like a very small group of people and they just vibe and they just enjoy themselves. And I thought, you know, I haven’t seen a boiler room set in a dental practice. So it’s on the to do list.

On the list of how do I make it different. So look, how do you see the future? Do you do you see it as some people have this sort of idea of one perfect place and you never get to perfection, so you’re constantly improving, constantly improving. I can tell you, after 23 years in business, we’re constantly having to improve everything. You know, it’s one of those things. Or do you see it as a scalable thing where you can have one of these in each town, or what are you thinking? Or is it too early?

I think I think it’s a bit too early to say. I can tell you from for me personally, and that I think it is relatively scalable. And I think that for the premise of our practice, or from the dental side of things at least, is prevention is key, regular appointments is key, and particularly guided biofilm therapy or hygiene every 3 to 4 months is what I recommend for that. It means that you need patients who are coming in all the time, and for one clinic which has 3 or 4 surgeries, that’s not, you know, and you build enough of a patient base after a year or two, it’s not going to work. So my idea is that we would maybe expand or scale this up so that you can have treatments done elsewhere, and we would still know about it in your like kind of core practice or whatnot. I don’t know, that’s kind of my idea at the moment, but I think that because we’re so hygiene heavy, we either need to have lots of hygiene rooms or we need to expand.

I think in the end, if you’re going to expand, you have to take yourselves out of it somehow. Yeah. And it’s so linked to yourselves right now that it seems ridiculous. It seems such a unbelievable thing. But you’re literally inventing the protocols around oral microbiome. You’re the one that’s sort of the tip of the spear of all of this. And so it’s quite a responsibility as well. But it’s something you need to get done. Right. You need to get you need to say, look, these are the protocols for someone who knows very little about it. Of course you’re going to train people. Yeah. These are the protocols. Yeah.

That’s what I think. For me, it’s not even scaling the clinic. It would be actually creating these protocols, teaching other, spreading the word to use it and for them to do it on their own patients. I think that’s my next step. It’s just that at the moment it’s been a struggle. You know, it’s early days, it’s early days. We’ve just opened and I keep on getting people messaging me, being like, hey, teach me how to do microbiome testing. I’m like, I’d love to, but I’m working, you know, six days, 9 to 7 pretty much every day. And I’m clinically full time and I’m owning a practice right now. So I’m trying to kind of readjust. And I think eventually in the next few months I will have time to do that, but not yet.

Okay. Well, I’m really, really proud of you. I mean, it’s so nice. It’s nice to see you get this far. I remember back thinking back to the early days of. Enlightened how much pain was involved. Maybe. Hopefully you’re not going to go through as much pain as I went through. But, you know, even the simplest thing, I was just looking at the door, just the sign on the door saying private. Yeah, someone’s going to find that sign. Someone’s going to stick that sign up.

It’s funny you say that Marianne got them from America.

Is that right?

She literally. When she went to America, she was there for a wedding. But she shipped the these toilet signs.

To her friend.

In LA, and then she picked them up from there because it was impossible to find the right sign, which was pretty, which wasn’t.

Right.

Which was right, which wasn’t too ugly. Like, you’re right, every single thing that now. And that’s one thing actually, you were saying, what have you learnt from your building kind of experience was now whenever I go anywhere I’m like paying attention to my access panel. Oh, look at that plumbing. Like I’ve become such a weirdo. I become obsessed with all this weird construction stuff and ventilation.

It’s so good to see you succeeding, and it’s nice to see you working with your sister and your mum, so hopefully it continues. Thank you so much.

Thank you for having me.

Well, Victoria has gone to see her patient and now I’ve got Arianne with me. Arianne I was I was talking to Victoria about the process of going from associate to principal and, and your situation’s sort of special, right? You’re a specialist orthodontist. You’re now having to take care of referrals to you rather than referrals to another practice where you work at. Yeah. Are you having to work at that or is that just flowing organically?

I feel like it’s a combination of the two. It’s flowing organically and I have a nice referral stream from Victoria and also from our hygienists here, and it’s because we’re we’re focusing on holistic dentistry and preventive dentistry. A lot of our hygienists play a really important role in referral to orthodontics, because it’s part of better dental cleaning to be to have straight teeth in order to get the interdental brushes through and things like that. So I get a lot of organic referrals just in house, even though we’re very new in terms of our external, in terms of external referrals, they’re still coming through. Even though I’m in a new location or offering a new location. And I think that’s just because of location convenience, but also because they trust the treatment that I’m providing. I’ve been taking on their referrals for a few years and producing what I hope are good results, because they keep referring patients back to me. So it’s been it’s been good. I do find it a little bit difficult sometimes to navigate getting referrals from general dentists who maybe feel uncomfortable referring their patients to a specialist orthodontist who is in a general dental clinic for fear of losing the patient to the general dentist there. And I completely understand that. So I am very careful to say to the patient that, listen, you’ve been referred to me for orthodontic treatment and I will provide that orthodontic treatment for you, but you will be referred back to that referring general dentist. So I am very mindful of, of the situation that that patient and that referring dentist is in.

So look, you’re we’re in a practice called the health society. Your is doing all of the microbiome stuff. You’re telling me that there’s a link between health and ortho. Yes. Because it’s easier to brush your teeth or I don’t know, it could be a traumatic bite or something. But mindset wise, as an orthodontist, if you not always thought of it as a cosmetic benefit rather than a health benefit.

Not really. I think a lot of people think orthodontics is just a cosmetic thing, and I think if that were truly the case, we wouldn’t have had it offered on the NHS for so long. It’s still offered on the NHS. I think there are very profound health benefits to orthodontic treatment. So you mentioned the traumatic bite. There’s that and in doing so will prevent where will prevent periodontal disease, will prevent collapse of the facial skeleton because it reduces the vertical dimensions over time. So we prevent all of those things. But I think also in terms of anterior open bites and poor poor lip seal, you have mouth breathers. And with mouth breathing you have snoring. It can put you at increased risk of sleep apnoea. And with Victoria we can see also an imbalanced oral microbiome. And so the orthodontics. Plays a big role in terms of rebalancing the microbiome and therefore improving the general health and wellbeing. So I take that responsibility pretty seriously. And then there are also links with the tongue, the lingual frenum, the swallow pattern, the I don’t.

Want to push back too much, but let’s imagine there were no aesthetic benefits whatsoever.

Yeah.

Would you still risk all the risks that come with orthodontics for the benefits that you’re talking about?

I think so, yeah, yeah, for sure. I wouldn’t have done it if I thought it was purely aesthetic.

No, no. But my question, my question if, let’s say there were no aesthetic benefits, said there was this new treatment that would reduce your microbiome, that would maybe sort out your bite a little bit, but comes with all the risks of orthodontics, which we can list them if we like. Right.

Would I still I still would be a strong supporter of Orthodoxy. So for sure there’s definitely a place and I think I think at the end of the day, we need our teeth and mouths and facial skeleton to.

I remember when I took my 14 year old for ortho, I wasn’t thinking about his oral microbiome.

You were.

But what you.

But what you’ve done is really helped out with.

It. Yeah, yeah. You’re right.

I also think, you know, and I take this really seriously and there’s, there’s weird inconclusive data about it, but they say that if you’ve had orthodontic treatment and your teeth are are straighter and you feel more comfortable with your bite. So, yeah, there’s the cosmetic, but there’s also the comfort. It’ll improve your confidence. And those kids with the improved confidence have better dating partners, have better job prospects and better longevity. And like literally longevity as in living longer. And I don’t mean to blow my own horn too much, but I do feel like I’m playing a part in this 14 year old’s orthodontic treatment. When they’re 34, they might get a slightly better partner because of a better job.

Well, the aesthetic.

Benefits are.

Profound. Yeah.

So the reason maybe I’ve got a bugbear about this is because sometimes dentists have such trouble talking about whitening, right. Because they see it as cosmetic and all that, and then they have no trouble at all talking about ortho, I see, because and in my view, you know, for most I mean, we’re sitting in a health society, but for most dentists, the benefits that they’re providing from ortho is maybe 90% of the benefit. The health benefit is 10%. But the reason why they like to talk about it is because we were taught to talk about it. Yeah. And we weren’t taught to talk about whitening. And by the way, whitening has a bunch of benefits too, right? It has. We just learned microbiome benefits. Absolutely. Yeah. It’s good for the gums and all that. But you know, maybe that’s my bugbear. Maybe maybe that’s where I’m going with that. Tell me about the process of opening a practice. The question I’m really asking though is like, what are the how long ago did you envisage this?

I when I was in dental school, as in studying dentistry, not orthodontics? Yeah, I remember we had to write a career plan. So a five year career plan and a ten year career plan. And I had option A and option B, and I don’t know why I had it this way, but option A was go down the specialist pathway and become a specialist orthodontist and work as an orthodontist. Path B was open your own dental clinic and my timescales were totally warped. I thought that I would be a specialist orthodontist within five years of graduating dental school, which is not possible. And then. Or that I’d have a clinic within within like a couple of years of graduating. I think that seed was planted in my head from our mom. She has such an entrepreneurial spirit, and so I always had it in my head that, okay, from dentistry, I want to be my own boss and this is the path to doing that. So that seed was planted very, very early on. I went down the pathway of specialist orthodontics, and when my sister was a dentist, it kind of made a lot of sense for us to work together. We happened to be working together in a clinic, both as associates, and we were cross referring a lot to each other within that clinic, and we saw that we were working really well together. And also as sisters, we know each other pretty well, and our values and our goals are very much aligned. And so for us, the prospect of working together was a no brainer. We’re in the same industry, so why not open a clinic?

But when I look at this, it’s so interesting because it’s very, very, very on brand compared to your Instagram pages. The art. Yeah. The what’s your page called? Dental Dental sisters and sisters. And it’s weird. Is usually you have a practice and then you have the Instagram page of the practice that’s supposed to reflect it. But your your Instagram page for Dental sister started years ago.

That actually started. We had a totally different name for it and we kept it very anonymous and it was more like fun images to do with dentistry to kind of break down the barrier of how scary dentistry could be. And so that’s how it started. We didn’t even have like our names or our faces to it. Then we announced ourselves as the dental sisters, and it was kind of just a fun thing to be able to, to make dentists seem more accessible and approachable. And I think that was helpful to do it that way around, because people liked us for our personalities as dentists and maybe shared in our humour when we posted like fun things about dentistry or shared in some of the research that we were putting out there also. And so we already had a little bit of that following before we got the clinic. I think when you open an Instagram page for a clinic, it’s tends to be pretty boring and a lot of people don’t really want to be following things like that. So doing it the other way around was helpful. And I think actually, to be honest, because we always intended to open a clinic, we we probably had that.

It was a good move.

Yeah, we probably had that in the back of our minds just to be ready.

So who is the.

Outlier amongst you because or are you all because, you know, there’s you can see there’s, there’s a, there’s an obvious move to for it to be different.

Yeah. I think it’s all three of us in a slightly different way. So I think for Victoria, clinically she’s the outlier because she’s doing a lot of clinical things that are not traditional dentistry. So that’s her for me. I think I have a huge focus on art. I think if I was not in dentistry, I would have been working in art if not being an artist. And so that was a really big focus for me in terms of just the design of the practice and making sure that we have our exhibitions and things like that. And then our mom, who’s involved, she’s the outlier because she’s bringing in that fresh, non Dental perspective on it. And so all three of us are outliers in different ways.

So do you.

Find sometimes your mom, because she’s not of dentistry, she’s not from dentistry. She’s sometimes pointing out something that you two never thought of.

Yeah, absolutely.

Give me some examples of that.

I think in terms of like people management or one of the things is Victoria and I just always call patients patients. It was it’s something that we always do. And to me calling somebody a patient is not implying that they’re sick. But for some people they feel that way. And our mom was like, why would you call them patients? Like if they’re coming in for maintenance, they’re not coming in for the treatment of a problem necessarily, like we should call them something different. And it’s just, you know, putting a new idea in our head. And I know some other people have thought that before within dentistry, but it was definitely food for thought and something that we we took on, which was interesting.

What else?

Um, I think also in terms of the practice design. I’m trying to think no, because in the end, I got my way. She didn’t want mirrors in the.

Dental surgery because.

She was like, oh, one wants to see those. So I was like, no, no, no mirror. So actually she.

Had that wrong.

Yeah, yeah. In the end I got my way with that. But I’m trying to think what else has.

She been approaching.

Businesses.

Outside. Yeah.

So in terms of.

Dentist find.

Really hard.

Yeah. At the end of the day we’re taught to be dentists. We’re not going to be good at everything. We’re not going to be necessarily good at marketing, good at all these things. And it’s the problem with dentists is they have to wear so many hats, and we have to accept that we can’t wear that many hats. So our mom has been really good with marketing. She comes from a marketing background, and so she’s approaching non-traditional audiences to help out business and so like local businesses and working with them. And that’s been really, really fruitful.

So your sister was telling me that rather than going for bank loans, you put everything you had in.

Yeah.

Tell me about like, the fear factor. How much how scared were you when you decided to do that? And how about from day one, you opened the place and there’s no patience, right? For me. I’ve never opened a dental practice, but for me, that would be the sort of the weirdness of, like, where do these patients come from? I mean.

Yeah.

It’s scary. It’s really scary. From the financial perspective. I think that that was probably the scariest, because I was sitting in earning money and then putting it straight into this. And so I think made money and then go to zero, make money in the good of zero. So so that is really scary. But I trusted the combination of the three of us enough to be able to trust the process. And I’ve spoken. I’ve spoken to so many dentists that we know who have done this in the past, and they all went through that fear. They all started from zero patients, and they all said it was going to be a massive challenge. They helped.

So specifically, you sought out dentists who had done squat practices?

Yes. Yeah.

How many did you talk to?

I think I spoke to, I probably spoke to like briefly spoke to like ten. But there were three in particular who I spoke with at length.

Throughout the process.

Yeah, yeah. And then so there was like one standout dentist who really helped us from start to finish.

Shout, shout him out.

Farid Muneeb shout out to Farid wannabe.

He’s also been a guest on this. Yeah.

Who’s help was was unbelievable throughout the process and really reassuring in terms of.

Sometimes.

What you need isn’t it? Yeah, simply that and it’s not.

Just being like, you’ll be fine, you’ll be fine. It’s like, you know what? This is really hard. This is a massive challenge. And like, you’re you’ll be prepared for it. So I think I really value that. And he had some really good tips and tricks and things like that.

And so what was the biggest mistake you made?

The biggest mistake I made.

What were you yourself you guys?

What would you have done differently?

Actually, one of the things was choosing our building and architectural team. We were told by a lot of people that we should go for a dental architect and a dental building team because they know the ins and outs of dental chairs and plumbing, etcetera, better. And I would agree that they do. And we inquired with a lot of them. And I found in the end we were wasting a lot of time entertaining them. When we eventually went with a non dental architect and non dental builders, we were recommended to use this building team by an art gallery. And so for them it was a big learning curve. They had never done a dental clinic before, they had never installed dental chairs. But it worked out really, really well. And I think again, it brought that freshness.

To this where Farid was involved saying, look, you need plumbing and piping and air. And I mean, did you know anything about this?

No, we learned so much about it. And that’s where. Yeah. So Farid came in and was like, where’s your compressor going to go? Because the building team didn’t know. Yeah. So that was that was really helpful. And. So I don’t regret. I regret wasting time with these Dental companies, to be honest, because I thought that. Um, I don’t know. The experience wasn’t too great with them.

I mean, building.

Like, sets up like that. In fact, it ends up like that every time. No one’s happy with their builders in the end. But you said. You said with the final team, you were quite happy. We were.

Really happy. I was really happy.

To hear that.

Yeah, I would use them again in a heartbeat. And I’d recommend them to anyone.

Yeah, I’ll get their number for good builders like Gold Plus.

Yeah.

So look, I asked your sister this. I’d be interested to see what you say. Look into the future. Where do you see this going? Some people have this idea of one perfect location, and I totally get that right, because perfection is so hard to get to. I mean, you never get to perfection, right? So you constantly improve, constantly improve, constantly improve. Some people say, no, I’m going to scale the idea, and I’m going to have several different locations where I’m not at, and I’m going to train people to work the way that I work. And and some people, they get even one level further and say, I’m just going to train the market. I’m going to become an educator. I mean, you’re definitely doing something new here. You know, the link, the link between author and microbiome in itself. Right? But then the testing, the health part of it, the gym and so forth.

What do you reckon? I think I’m.

In that second camp, so I definitely want expansion. I feel like this would be a sort of flagship site, and then we’d have smaller spoke sites for our patients to, to visit that are closer to their, to them. We have a lot of patients who travel from far to get to us here actually. And yeah, I think it would be great to scale and then expand in that way. That’s that’s what I see in the future.

I mean, it’s.

Very early days to ask this question. Yeah, yeah, I get that. I do get that. So let’s imagine three years time this this model is very room heavy. Right. It’s very hygienist heavy.

Yeah. Yeah.

Three is time. There’s absolutely no capacity left in this building. God willing then are we are you thinking literally replicate this in other locations?

I think I’d replicate the hygiene in other locations. And then this is our Dental flagship.

Oh, yeah.

And the salivary diagnostic flagship.

That’s interesting.

Yeah.

So then you have maintenance everywhere else.

But then. So we’re not saying there’ll be an orthodontist in every site. No.

I already travelled so much as it is, it doesn’t have for you know, I know, I know.

But no, I don’t think there’ll be an orthodontist at every site. The magic of orthodontics is that I only see my patients every couple of months over an extended period of time, but it means that your time commitment is not as much juice.

Dental monitoring.

No, I don’t actually. I know about them.

Amazing. Yeah. Amazing. Yeah.

And I’m looking at from the patient perspective I mean my my daughter’s going through it. Yeah. And she hardly sees her really. You know whether that’s a good thing or a bad thing. Yeah. Yeah. The orthodontics compared to my son who didn’t have dental monitoring, who was going in once a month paying those parking things in Harley Street, totally different amounts of you can see as a, as a guesstimate. I reckon you can see 4 or 5 times the number of patients. Yeah. Because, you know, I’m sure her orthodontist is looking at something like looking at the scans or whatever it is. Yeah, but she’s visiting very little. I’m really surprised at how little she’s visited. Yeah. And, you know, it’s Invisalign and the teeth are kind of getting there.

I think it’s a great idea. I’ve but I’ve noticed with some of my patients they feel the need to come in and see someone.

But I’ve it’s headache though.

You know, once, once a month I want to turn up at the dentist.

Yeah, yeah I agree it’s a lot.

And it’s worked out really because I have patients who see me from from San Diego, from Zurich. Yeah, yeah. And it would make their lives a whole lot easier. My patient in Zurich flies in for his appointment and goes straight back on the plane to.

Zurich once a month.

Yeah, pretty much.

Once every six weeks or something. Yeah, yeah, yeah. And it’s crazy. It’s crazy.

I mean, I’m honoured.

Did you tell them that there are some good orthodontists?

You did no harm at all.

So, look, you’re doing your clinical bit. Your sister is doing her clinical bit. What are the bits you’re doing around the actual running of the practice? What’s what’s the bit that you’ve grown into?

So I did a lot of the legal stuff. I did a lot of the contract things with our freeholder contracts with the companies that we work with. I did all the stuff, which was a huge, huge learning curve. Yeah, because you can.

To do it. Yeah.

But then I just worried that at the end of the day, we were going to be interviewed in person by the QC inspector. And so I might as well write all the policies myself. And then I can answer the questions better.

Orthodontist OCD sort of thing.

Probably. So.

So I did all this stuff.

But what about.

Now? Now in the running. Are you doing hiring?

Yeah. Hiring? No. Hiring is all three of us. We take, like, equal load with that.

I’m. I don’t know if you fired anyone yet, but it’d be interesting to see who the Fire Robo is going to be. Yeah, I think they will.

Be a well, I don’t want to take that. And then, like, in terms of, like, staff HR because it’s contracts. That’s me. I’m just the contract person. When I was applying to dental school, I was deliberating between dentistry and corporate law. And so I guess it’s fitting I can.

See it as a corporate lawyer, actually.

That’s right.

So I guess it’s fitting that.

I’m doing it’s one of those.

Weird sort of sliding door sort of moments. Right. Imagine you’d gone that route. Yeah. And I know some corporate lawyers are tough life. Yeah, tough, tough life. Not the orthodontist. Life is easy, right? But tough love. And so interesting. Right? Why do you end up. Why does one end up doing the things that they do? Sometimes comes down to something almost insignificant.

Yeah. For me, I couldn’t really think of what to do. My mom organised tons of work experience for me in dentistry and in law, and a bunch of other things, and the dental work experience I did with an orthodontist. So shout out to Siamak Bagheri and and then also with a general dentist. And I just thought it was less boring than law and that was it. It was literally just like, okay, I’ll do dentistry. It was a little bit less boring and that was it.

And but, you know, like in that moment.

If that day someone had come in for the lawyer and talked about something interesting. Yeah. You literally your life might have been completely different to what it is today.

Absolutely.

Interesting thing.

Yeah, absolutely.

You know, I know it’s not the same thing, but we were talking about this on holidays, right? Why is it some people want to go to Bali and some people want to go to Australia. Yeah. And when it comes down to it. Right. Yeah. You could have had a friend who’s been or you could have done a bunch of research. A lot of times it’s like, there’s no reason why Bali is this place that I want to see, you know, it’s just a thing in your head.

Yeah.

It means nothing.

Well, that’s what you know.

The. Who’s that magician? Is it David? No. Not David.

Oh, Blaine. Blaine.

No, the other the the ginger guy, what’s his name? And he puts, like, subliminal messages all around.

Yeah yeah yeah yeah yeah. To the to the performance. So it’s kind of like that but like the. Yeah. Yeah you’re right, you’re right.

So yeah, maybe the subliminal. Maybe your mom’s been putting orthodontists into your head since I’m.

Six years old.

Yeah. How does it work with me? I’ve tried.

It with my kids.

First. Not yet.

I’ve heard subliminal.

Messages were just to do dentistry. And then when I was a dentist, I was like, I’m going to do ortho. And she was like, what? Why? Dentistry is fine.

No, no, no.

You clearly love it, though.

Oh, I love it.

I really didn’t like general dentistry, if I’m honest. I think if I had remained a general dentist, I probably would have quit by now. Really? I really disliked it. The only thing.

You dislike so much.

I think. To be very honest with you, there were elements of dentistry that I didn’t feel like I was good at, and I’d sit and I’d do a filling or whatever it may have been, or veneers or whatever. The patient would have been fine. But I was looking at it and thinking, if somebody had done this to me, I wouldn’t have been. I wouldn’t want me doing dentistry on myself. And that really upset me. And then I did Max facts.

And I was honest with yourself. Yeah.

And I was doing Max. Max and I was taking teeth out and I was like, I would allow myself to take out my own tooth. So I was like, this is the feeling that I want. I want to be able to trust myself to do it on myself. So after that, I was like, okay, I like oral surgery and orthodontics and that was it. So I would do orthodontics on myself.

And I remember in our last podcast, you were going to actually do medicine and Max, Max and all of that. Yeah, yeah. And at the last minute you just decided, yeah, sanity went over.

I’ll stick stick to the original original plan. Yeah, yeah.

Well, it’s been so amazing to come and see this place.

I’m so glad you’re in the flesh.

And I’m really proud of both of you. You know, even to even just. We were just talking about, you know, the toilet signs, which I hear you got from LA.

Yeah.

So even something as simple as that compared to, like, you know, manifesting this whole place. Yeah.

By the way, how.

Hard was it to find it.

To find the location.

Location?

How long did you look.

Oh, so we we started looking maybe a year before we even found, we found the place not even started building, and it was just kind of on the back burner. I was on all of the websites to get notifications on new properties in the area.

I put websites on it.

Um, oh, there was some. Oh.

Was that shop, shop.

Property or something?

No, some. I remember calling it real LA. And then somebody was like, no, it’s real LA. So so it’s okay.

So you were getting a bunch of emails saying this shop’s come up.

Yeah. And they were.

Just because there was a change in the laws in terms of your.

D1 and all.

That. Exactly. So after that, suddenly everything was, was, could have been available to us. So I was getting all these notifications, I was seeing a lot of the properties and, and I liked Mayfair. I felt like there weren’t enough dentists in Mayfair.

And so then did you think.

I am going to go? I am going to have a practice in Mayfair. Like, were you only looking at Mayfair, or was it that this came up while you were looking in other areas as well?

I was looking like 90% in Mayfair.

Where else were you thinking Harley Street or no.

No, it’s so saturated. I didn’t I didn’t want to do that.

So you wanted a shop frontage sort of situation? Yeah. Retail kind of situation.

Yeah, exactly.

And then I come across this site and the agency that was advertising, it wasn’t answering any calls and wasn’t answering any emails. And I thought it was suspicious. That almost made me more hungry because it was like, normally people want to get rid of their place. And it had remained empty for at least a year. And so I contacted this guy called Guy who, who kind of does deals in, in real estate. And he was like, I’ll find out for you. And he got us a viewing. But it took me a really long time. He got us a viewing. I have no idea why they were so weird about showing this place to us, and we just absolutely fell in love with it.

And it was an art gallery. And you said there were no walls at all.

No walls. It was all totally open plan. They had one room downstairs, which was their staff room, and that was it. And which is perfect because it means we don’t have to knock anything down. All we have to do is erect the walls.

And it’s cool because it’s.

Kind of a blank canvas, isn’t it, that you can.

Exactly.

You can literally make your own mark on.

Yeah, exactly. And they had all of the wall hanging mechanisms for when they were exhibiting for the art. And we have some and use the same ones of course.

And the place is full of art.

Yes, which is a.

Really big focus. So you mentioned that got the toilet signs from LA. Yeah, a lot of the art from LA to carrying in my suitcase.

Amazing. I’ll remember not to return your calls so that you get even more. Yes. To get in touch with me.

Thank you so much. Thank you for.

Giving us the time of your practice. I know you’re so busy, so amazing and good.

Luck with it. Thank you so much.

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

Thanks for listening guys. Hope you enjoyed today’s episode. Make sure you tune in for future episodes. Hit subscribe in iTunes or Google Play or whatever platform it is. And you know, we really, really appreciate it. If you would give us a.

Six star rating.

Six star rating, that’s what always leave my Uber driver.

Thanks a lot, guys. Bye.