Speaker1: And I’m glad that it’s now probably more accepted to go outside the curriculum and get some learning through mini smile makeover or other means. Because with clinical exposure reducing since I left and since you left, dentists coming out are not as experienced with all the procedures, so they have to do more learning when it comes to private education, shadowing, reading. So if they can do that early whilst they’re in dental school, in this protected environment it’s all the better.

Speaker2: This [00:00:30] 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.

Speaker3: It gives me great pleasure to welcome Sahil Patel onto the podcast. So he a young dentist who’s making lots of waves from where I can see he’s just got accredited at the OECD, which [00:01:00] I saw, which is a massive achievement. Having watched Dipesh Parliament go through that process as a what a massive achievement that is. So congratulations on that. So he’s opened his own practice in the West End, Marylebone Smile Clinic Clinic, Melbourne Smile Clinic recently, where he’s focusing on aesthetic and restorative dentistry. I actually was in the lift at the OECD and a couple of the examiners were asking too, so how was the Hills work? And there was a [00:01:30] knowing nod. And in that lift, knowing little knowing nod saying, you know, it was it was excellent work and we could see your work online. The other thing so he has done a lot of is, you know, just get himself out there and educate the public on, you know, all the different parts of dentistry. But this time, you know, our audience is mainly dentists. So maybe a bit different to the focus you’ve had. Thanks a lot for coming in for this.

Speaker1: Thanks, Payman. Thanks very much for having [00:02:00] me on. And the comment about the lift I haven’t heard about, and I thought it would be a different answer because they gave me a specially a hard time during the viva, and I’ve been telling stories about it since. I enjoyed it a lot. I wish there was a recording of it, because such useful debates and discussions amongst very knowledgeable people asking me questions about cases. I found it helpful and yeah, stressful.

Speaker3: So take us back. [00:02:30] Give me. Give me your backstory. Sahil. As a kid, where did you grow up? When was the first time dentistry came on your radar?

Speaker1: Grew up in north London, and dentistry came up relatively late in the thought cycle or application cycle. When kids go through lower sixth form and are asked, what do you want to do at university? I was encouraged to do medicine. I looked around me. Lots of my friends. My older brother had gone to medical school. Yeah. Me too. And one [00:03:00] thing I asked myself at that immature age was, how do I want to spend my time outside of work and inside work? And I always knew I had interests outside of dentistry. So quite selfishly, at the time, I thought, I’m being told I’m good at biology. I like working with people, but also would like to do things at my own time as well. Dentistry seemed to allow for that, or at least on the face of it. And those were the core reasons why it appealed to me. There was no innate passion for teeth, I don’t think. I don’t think anyone has that.

Speaker3: I [00:03:30] asked this question a lot. Right. And you do get there tends to be three answers to it. One is kind of the one you gave late, being sort of soberly looking at how you want your career to turn out. There is another one which is I had a great experience at the dentist myself, and from then I decided to be a dentist, which is a lovely story, right? Which means people are treating people well. But then sometimes you do get these people who say, I want to be a dentist since I was five years old. It’s rare. I find that.

Speaker1: Hard to hard to relate to because [00:04:00] many people ask me to this day, why would you want to spend your time looking in people’s mouths? You know, on the face of it, it seems like quite a squeamish thing to do. So at a young age, having a passion for it or innate passion for teeth. It’s exceptionally rare for me. That came a lot later. Was there anything.

Speaker3: Else on your radar apart from medicine, dentistry? When were you thinking maybe, I don’t know, engineering or law? Some some other angle in another life?

Speaker1: I would love to have gone into film production. Oh, really? [00:04:30] In another life, I would have loved to have tried to become a professional performer in some way. I did a lot of dance through university and through school. I continued to this day and Hollywood used to be Bollywood house and locking through university and then competing in Latin and ballroom through university. So that’s what I do. More recently, a couple of colleagues I know did go pro and you know, I live vicariously through them. It’s a tough life, but also an amazing and very different life to clinical [00:05:00] dentistry. So those are the two things I would fantasise about.

Speaker3: So performing. So that really puts it into sort of focus that like watching your social media, how comfortable you are. And I remember looking at it when you started really going in all in on it. I remember thinking, these youngsters are just so comfortable in front of a camera, you know, they just find it so easy. But were you lots of plays and school plays and that sort of thing as well as you were growing up?

Speaker1: No, I’ve actually [00:05:30] never been into acting or singing or dancing specifically. Dance. Yeah. Which has an element of acting to it. Yeah, but coming to recording yourself on camera, I didn’t think of it so much as performing and it didn’t. Come naturally to me. Although you said it does.

Speaker3: Seems like it does.

Speaker1: I think having confidence in what I knew and what I was discussing seemed to help, because it didn’t require me to rehearse lines. None of the videos I do.

Speaker3: Was it ad lib?

Speaker1: 95% of it. [00:06:00]

Speaker3: Oh, that’s so interesting. Sam Jethwa said the same thing to me and I couldn’t believe it, man. I was like, Jesus. Even the bigger achievement.

Speaker1: People can see very quickly. When you’ve rehearsed something, you can see through it. People know when it’s not authentically you. It’s true. And I was very aware of that when I did try to write something out that was, let’s say, complicated. You look at, you watch yourself back and you think it doesn’t look genuine and you wouldn’t buy it. And I think when it comes to health care, people are looking for relatability. Very true. They could see if you’re not being [00:06:30] truthful in that moment just through body language. So I was very aware of that. And I think if it doesn’t, usually when if it doesn’t come through in the first or second take, it’s not going to be better than that.

Speaker3: It’s funny because there’s a camera on right now, isn’t there? And somehow I can ignore it because I feel like we are just chatting and then it happens to be recorded. Whereas if I’m standing in front of the phone, it’s not just me. Maybe that’s the way to think of it. And maybe that’ll be the the my answer to my problem. But [00:07:00] I can’t talk to the camera as I hate it. Completely hate it.

Speaker1: I had a little bit of the same issue because you’re looking into a lens which is not looking back at you. Yeah, exactly. But right now I’m looking at you exactly. When you look at a lens, you’re just seeing a very small reflection of yourself, and there’s no one there. And I’ve had to break that down by repetition. And I think that’s probably how most people do. You then become more related to the camera, which is an odd expression, but these days I don’t think of it much.

Speaker3: Well, I can see that you do look comfortable now. [00:07:30] So tell me, you decided to go for dentistry. Was there a thought process of I’m definitely leaving London for university or what? How did you end up in Bristol? Why Bristol?

Speaker1: It was the only university that gave me an offer. Yeah. I desperately wanted to go to King’s College because all my friends were going there. Yeah, it has a good reputation, especially amongst secondary schools. Yeah. I was really upset to go to Bristol. I was torn and I was at the time I was childishly. [00:08:00]

Speaker3: Though now, in retrospect.

Speaker1: Very much so. I think as a teenager growing up in north London, you think you.

Speaker3: Know it all.

Speaker1: And the world revolves around London, outside the M25. Nothing exists. And I was of that mindset and foolishly, it was the best thing I could have done to separate from a circle that I knew very well and find out that actually, outside London, there are all sorts of worlds which are just as good, if not better. And I threw myself into Bristol life, and it took a couple of years to actually [00:08:30] become settled and feel like it was more comfortable there than I was at home. And afterwards I didn’t want to leave, and I was really sad to leave after five years, just as torn to leave and go to a new, new place, which was even remote area. Cool. Yeah.

Speaker3: To get to. I adore Bristol. I love Bristol, it’s one of the towns in the UK that I could live in. Me too. I studied in Cardiff and we used to visit Bristol sometimes for whatever [00:09:00] it was. But I love Bristol so much. I visit Alfonso and the Touraj and Richard Field and it’s a great town and there’s great restaurants, great people, great people. So, okay. How were you as a as a dental student? Were you top of your class or not?

Speaker1: No, I would say I was average right in the middle. As time went on, I became disillusioned with dentistry. In the first three years, I think. I didn’t know if it was something that I enjoyed. [00:09:30] I knew there was an academic component, which you’re trained just to go through the phases of that, and then you start to see patients and you start to realise what the job and the task really entails. And I struggled. I was not particularly good with the practical learning of my hands. I was I was lagging behind and a couple of colleagues who I stay in touch with today, the three of us were comparing notes as to how bad we were because we were just rocking right at the bottom. And [00:10:00] as time went on, I had some influence from a couple of dentists. You may know Nick Claydon, he has a practice in Cardiff. He made an impression on me early on and I was lucky enough to go and visit his practice, and that changed my mindset as to what dentistry could be. It was a stark contrast to how the dental hospital ran things, and something in that gave me a lot of motivation to explore what’s outside of the dental school. And he actually was the first one who pointed me towards the British Academy of [00:10:30] Aesthetic Dentistry, and he just said the name and I didn’t know what it was. And that academy is not particularly well known compared to the BCD, which you mentioned earlier. And then from there I met Richard Field and became a student rep. All of that, and that gave me a lot of motivation to become quite rebellious as a student in the final clinical years. I was trying to break out of it early, I’d say, which is good and bad, but.

Speaker3: So you’re saying that Nick sort of inspired you to go after excellence, whereas the dental school [00:11:00] didn’t?

Speaker1: Nick encouraged a patient journey and he showed me that journey from his practice. What happens when the patient walks through the door, sees him, sees the treatment coordinator, and then leaves with a treatment plan? I’d never seen that in my life. As a student, you’re you’re arranging the appointments. You’re trying just to get them to a point where you can have a treatment plan that you can actually.

Speaker3: The experience side of it kind of seduced you, that you want to create the best experience for the patient.

Speaker1: Yes. And until then, I felt dentistry was [00:11:30] quite barbaric in the, in the methods we’re using. And I felt it’s just quite aggressive and it didn’t seem very pleasant for the patient. And he made it seem so pleasant in his practice, the way he designed it, the workflow. He had a lot of chairside CAD cam never seen that before. When you see that for the first time, I think everyone is very, very impressed. Yeah. You see a cerec machine for the first time, or you see a scanner for the first time and you’re and, you know, you go back to our dental schools and we’re mucking around with silicones and things.

Speaker3: What did [00:12:00] you call it for 2015? And there was no mention of scanning or anything. I suppose scanning wasn’t what it is today. Well, it’s.

Speaker1: Interesting since seeing Nick use Chairside cad cam, I went to go I went to the lab in Bristol and I asked them about this and they said, yeah, we’ve got a machine, but no one uses it apart from our head technician for some some inlays and onlays and he showed me it. It was a red cam from 2002, gathering dust in the corner. And he used it every so often. Not on not [00:12:30] on technician. Technician used it kind of in the lab setting too. Never, never, never scanning a patient. And I did a lot of research at that point. And I got what I would call obsessed by the aim of using this machine on a patient as it was intended. I must have read so much stuff on Cerec, doctors from Scottsdale, all those guys, and I just searched for a case that I could do this on and tried to get competent with something that no one would teach me. So I got models, I prepared models, I did it on a model. [00:13:00] I showed the technician. The technician took me under his wing and actually gave me advice on what to do. I found a case in fourth year and we did it. Three hours start to finish and only from preparation to fit. It caused a lot of upset in the dental school because it had never been done.

Speaker3: You haven’t passed it by anyone?

Speaker1: No. Well, I’d passed it by people, but it just never been done before. And people were just certain people were understandably confused as to why a dental student is calling [00:13:30] the shots. And in hindsight, I can see why I don’t have a license. That being said, I’m being supervised by dentists, so I still I still feel it was okay and clinically it was the right treatment for that. But that was that was a great moment. And then I did it again before graduating. And then unfortunately, I think think didn’t manage to pass on that to anyone else because the barriers are just so high when you’re a dental student. But all of that led to all sorts of different things, such as clinical photography. Richard was guiding me quite a lot at that stage.

Speaker3: So [00:14:00] you were in touch with Richard Field as a student because of the student rep situation? Yeah, yeah.

Speaker1: Richard was just recently having been a student rep and he was recruiting for student reps, I believe, in Cardiff, in Bristol, and I remember at the time you’d have to write a short application. And Richard being the relatively intense guy that he is, I remember having a conversation with him and he mentioned a few things. I just never heard of things like deep margin, elevation and as a fourth [00:14:30] year student at the time, completely alien to me. Then I started reading about them and I realised there’s a whole world of information, techniques, clinical teachers who are far, far beyond the UK and the UK is playing catch up and lagging behind. That was what I felt then. I feel that now.

Speaker3: So and you were accessing these people on social know or did you go on courses abroad or what did you do.

Speaker1: Courses, a lot of reading of literature, a lot of [00:15:00] shadowing of dentists. I found didactic learning was helpful for giving background, but for me, seeing what people do chairside made me confident enough to actually do it. And one thing I noticed was some clinical teachers do slightly different things on a training course, or they teach different things versus chairside. And particularly with composite resin bonding, so many techniques out there, some people actually are more pragmatic with a patient versus in teaching where you’re learning Floss ties, let’s say technical gold standard. Yes. [00:15:30] Then when you have the cold face with a patient, you may do different things.

Speaker3: And so how did you go about asking people if you could shadow them, literally DMing them, or how was it? I mean, because in my day, shadowing people wasn’t really a thing. Whereas I spoke to some dental students and they were saying, yeah, any time I get a minute off, I go and nurse for a senior student or or shadow a lab, go to a lab and just watch a technician building. [00:16:00] Building a. Lab work, which is like it sounds amazing education. But when I was a third year dental student, you wouldn’t have caught me in a lie. The thought didn’t even cross my mind, let alone doing it. So tell me about that. That shadowing process where you pick picking people you really respected a lot, and just directly asking them if you could shadow, was that it? Yes.

Speaker1: The first one was Nick Layden. He gave us a lecture on oral hygiene instruction as think second or third years, and I dropped [00:16:30] him an email to really say thank you for the lecture. And he did talk about his practice during the lecture. And I thought if he was willing to allow me to shadow him, that would be great. I was just intrigued. At that stage, I didn’t realise I would learn so much. And he kindly said yes. And I think from his point of view as a referral clinic, it made sense as well because I have referred patients to to his clinic since then. So I think it was a win win there. When it comes to being post qualified, it’s a little bit more complicated because I think a cold [00:17:00] or a cold email probably will land flat because there’s no particular reason dentists would would allow it, because there are complicating factors and having another clinician in the room, it can it can cause patients to feel as if the dentist is being supervised, depending on the age difference between you two. What I tend tended to do, I think if I had a pre-existing, even a relationship with that dentist, such as if I’d seen them on a course, met them socially, or conference conference. And at Bard when I went, I went to that as [00:17:30] a 50th student, and I met so many dentists who were significantly senior to me, and they all seemed eager to pass on what they’d learned to someone who’s the youngest there by ten years. And I’m thankful for that because many people said yes, the majority said yes. People such as Jason Smith’s and Teju Manku, Mark Hughes, all these people. I learned plenty from Chairside.

Speaker3: Wow.

Speaker1: And my approach. And how long were.

Speaker3: You shadowing each of these guys?

Speaker1: Probably varies from 2 to 10 [00:18:00] days.

Speaker4: Wow.

Speaker1: And, you know, at the upper end of that, if you if you shadow someone for ten clinical days, that’s a lot of clinical dentistry. You’ll see and you’ll see a lot of different approaches and complications. And it’s interesting to see again.

Speaker3: Bloody good point about being as as a dental student getting as much sort of, you know, exposure to conferences, meeting people, going by the way, we do this for many spa makeover. We let students come for free. Okay. [00:18:30] It’s almost for me. It’s almost like a like a laboratory rat situation. I want to know what happens to these people. There’s one in particular. I got him in the first year of dental school. Wanted to know. I wanted to know what would happen. So on the hands on in the first year of dental school and unfortunately, unfortunately, he was holding the composite gun upside down and stuff and you realise, you know how much you actually everyone in the room does know. Whereas usually when you’re teaching you’re thinking, oh, well, [00:19:00] I’ve got to teach all this new stuff to people. But he’s gone on to do, he’s in his fourth year now, so he’s gone on to do a lot.

Speaker1: And as he stuck with the mini saw makeover group.

Speaker3: I’m just trying to expose him to as much stuff as possible just to see what would happen. Yeah, okay. But anyway, the guys have come and watched. They’ve been firstly keen, taking notes, asking questions, meeting people and there’s pleasure in it, man. There’s pleasure in in propelling people forward. You know paying [00:19:30] it back. I mean you must be getting people asking you now right?

Speaker1: I do and how do you handle it? Just like you, I, I like to give it back as well. Yeah. And most cases I say yes and I say most because the only situations which can be problematic is certain personality types who may not wish to have other people in the room, even if they are a dentist. Also, as a young, younger dentist with a young dentist in the room, sometimes that can be a [00:20:00] miscommunication as to who is watching who and who is actually who is mentoring who patients can. Sometimes it can cause a problem for yourself, and I’ve seen that happen for sure. So it’s usually helpful if there’s a big age disparity because there’s no miscommunication. But when it’s quite close it can be problematic.

Speaker3: So yeah, you can have to wait a few years because now now you’re going to get loads of people asking. But it’s it’s important though. It’s important. I don’t know why. In my day just was not a [00:20:30] thing. And it really is the best way to learn.

Speaker1: It’s good to hear that people are doing it. Early years I remember when I was doing it, I was very much the black sheep in the year. I wouldn’t to the point where I wouldn’t tell anyone because I was already being criticised for going outside the curriculum. And for example, I was speaking to Heraeus Kulzer at the time, and they were helpful to lend me some composite to try and use instead of using 0.4, which they still use in Bristol, just to try and improve the quality of outcomes in posteriors. And I was really criticised heavily by clinicians and students. [00:21:00] I’ll just keep it all to myself. And I’m glad that it’s now probably more accepted to go outside the curriculum and get some learning through. Mini smile makeover or other means. Because with clinical exposure reducing since I left and since you left, dentists coming out are not as experienced with all the procedures, so they have to do more learning when it comes to private education, shadowing, reading. So if they can do that early whilst they’re in dental school, in this protected environment, that’s all the better. [00:21:30]

Speaker3: Absolutely. I mean, the early years are so formative. And we were discussing off mic, you know, what advice would we give to people? And you made the very good point that we tend to give the advice that’s based on our own experience. Although, you know, I’m not advising people to go start a teeth whitening company, but you’re right in that, in that we all have our own sort of lens that we put in front of the advice. But you went from university [00:22:00] to, I guess PT in Cornwall.

Speaker1: Yeah. Df1. Yeah.

Speaker3: Df1. That’s right. And and then from there straight to cosmetic private dentistry. So. Right. Yes. Okay. So so so tell me about why Cornwall first of all and how was the experience?

Speaker1: Just like my upper sixth application to dental school had one offer then and the only offer to Cornwall at 50 a dental school. I desperately wanted to stay in [00:22:30] Bristol and I was, I think I cried the day that I found out that not that I was going to Cornwall, but I actually didn’t get a position. I was one of those few who didn’t get a position because you ranked so low in the country. And at the time, if you, you know, I was possessed with dentistry and all these different things, and I was just really sad for a period of time. And then after graduating, after passing finals, I found out it was Cornwall. On one hand, I was sad to be leaving Bristol, but number two, on the flip side, I thought it’s a new place, [00:23:00] why not go head first into it, just like I did at Bristol, maybe there for one year or two years beyond. And then I knew Jason was there as well. So that was one of the first things I had on my on my list was to introduce myself to Jason. Before that, I hadn’t met him. I worked in a practice in Wadebridge and two trainers, both of them were lovely, taught me loads about clinical dentistry, and what’s nice about the sticks is that you often get exposure to a wider group of people because [00:23:30] there are less dentists per area per square mile, and in Cornwall in particular there are, there’s a severe lack of certain specialities. Periodontics, prosthodontics or surgery. So those things we would try and bounce the referrals to, to Exeter or Treliske in Truro and sometimes get bounced back to us saying, sorry, we can’t take this patient on for X, Y and Z. So my trainers and I would say, well, let’s let’s give it a try. And as a result you get [00:24:00] amazing exposure to learning.

Speaker4: Yeah.

Speaker1: Which I’d heard in big cities you don’t. So for dentistry it was great. And although I was the youngest person I knew in Cornwall, I got some nice exposure to triathlon. Cycling is amazing out there, so there are lots of positives from it, and I threw myself into a lot of courses at the time, and shadowing did a lot of miles that year in the car. And to answer your question, to then apply for positions I. My priority was not so [00:24:30] much to go into cosmetic private practice, but to find a practice that would support the, let’s say, the educational pathway I was on, which was essentially to treatment plan comprehensively. That was sort of where I was at at the time, improve my skill sets. And and in order to do that, I wasn’t focussed on finances, not one bit. I would spend a lot of time and a lot of stuff, and that doesn’t work with a lot of practices because practices are businesses. And at that time I was jaded for that. That was not really on my radar. So I was searching [00:25:00] for practices that would accommodate that, which there aren’t many. So I sent out a lot of a lot of cold applications. I guess I got some very nice responses, actually, because I did put together a portfolio of sorts based on what I’d done and since fifth year to end of Df1. And I did eventually have people respond positively, and I took on, I believe, three positions, one in south London, one in central London and one in Hertfordshire, and split my [00:25:30] time for that for, for those three practices and, and started a very, very steep learning curve.

Speaker3: And when you said portfolio, are we talking Instagram at that point or. No. What, what how what shape did it take this portfolio. Was it when you you’d send an application, would you just send the photos or on hard paper.

Speaker1: Oh paper I hard paper I’d got them printed professionally. Oh and in hindsight I’m not sure if it was a good move. I think it was, because [00:26:00] I remember. Getting some phone calls.

Speaker4: People who stood out.

Speaker1: Who actually thought what I was doing was the right way. And and a couple of people come to mind. Nick gave me a call from Cardiff. Yeah, yeah. He didn’t have any space at the time, but that’s understandable. Kamal Suri gave me a call. I’d never met her before, so. And she invited me over to have a chat to her, which was great. And through BCD it was sent out as well digitally through through. Suzy and I received several calls from them because I [00:26:30] didn’t know a few of them by that point, so I had it printed.

Speaker3: And what were the cases?

Speaker1: The cases were the cigarette case, the one that I worked so hard on and it turned out great. There was a fibre post core and crown, which by fluke was a good shade match. Um, and I think there was a single tooth bonding which I used enamel on, I believe. Oh, nice. Yeah. And I think I may have sent it to you at the time as it.

Speaker4: Just rings a bell. Yeah. [00:27:00]

Speaker1: Years ago, I remember I spoke to you about it. So, so very simple things. Things that turned out well. And at the time I was photographing different stages of things which most people are not taking any photos at all. So I think, you know, even producing one case from a dentist. Now, if I see one case from a dentist, you know, it elevates them so high because I think 80% do not.

Speaker3: It’s interesting man. We can you can track that way of progressing your career right back to being a student rep at BCD because [00:27:30] of the people you were meeting and the lectures you were watching and and so forth. Get yourself a camera, get yourself some loops or whatever it is, and meet all these people to shadow. So the three practices Hertfordshire was with Rahul?

Speaker1: Yes. Perfect. Smile Studios, Hertfordshire. Yeah. So at the time it was girls Sammy, oh Sam Jethwa and I and interestingly, as I entered that practice, I, Rahul was planning the last ever cohort of the course [00:28:00] that he used to run. You may not have you may have heard of the course, but no one else will have because the course has not been running since 2016 and it was an internal only course. So it was just 4 or 5 of us. And I went straight into that, and that was treating a live case for ceramics. So that was a very steep learning curve, but it was amazing.

Speaker3: I used to visit the practice with the enamel for that course. Yeah, a few times. And what were the other two jobs?

Speaker1: Oh, the 210 Dental Clapham and oh [00:28:30] nice, Nick and Martin. I’d credit them with teaching me much of what I know about implants. And yeah, two great practices there and then Harley Street small clinic with Maurice Morris. Johannes Morris. Johannes.

Speaker4: Yeah.

Speaker3: What a group of people you’ve been you’ve been exposed to because and we’ve obviously we’ve had both Nick and Martin from ten Dental and two different angles on Implantology. Right. But then Maurice, Johannes, a lot of people don’t know Maurice, but Maurice was one of the original guys in dentists, [00:29:00] which was one of the.

Speaker4: You say.

Speaker1: Dentists, not dentex.

Speaker3: Dentex was the original cosmetic shop front practice in London. The the first really that did it shop front. I mean, there were definitely cosmetic dentists before that, but in more sort of West one locations. But this shop front and he partnered with a PR person and they gone into the at the time it was you know Vogue and and all of that. They used to get their story. But when I, when I was trying to get enlightened into that [00:29:30] practice because I’d made this ridiculous thing in my head that if I can’t get into that practice, I might as well just give up. Right? And I had they put me in front of Chris Hall, okay, who was the clinical director and had Chris sore asking me, where’s the evidence for this? And it was at the time light activated teeth whitening as well, which okay, doubly difficult. I remember I visited that practice so many times trying to get this product in, but um, but Maurice was one of the original guys there. He was.

Speaker1: Yeah, I think it was [00:30:00] him. Joe Oliver and.

Speaker4: Joe Oliver.

Speaker1: Mervyn Drian. But he may have not been in the same practice.

Speaker3: Anything but.

Speaker4: But Mervyn was, you.

Speaker1: Know, I believe he’s older than. Yeah, he’s older than Maurice. But he was always in Swiss.

Speaker4: Saint John’s Wood, Hampstead. Yeah.

Speaker3: Yeah, yeah. But so Maurice Wood at the time was just doing Paul Simon ears all day.

Speaker1: To this day, to.

Speaker3: This day. And so you were perfect smile cosmetics, Maurice veneers. Were you doing veneers also?

Speaker1: Yes, [00:30:30] I was his support in the sense of people who did not want veneers. So let’s say composite bonding, tooth contouring, gum lifts. I was on that side. But as time went on, I did more and more ceramics cases and as yeah, as a result, I did a mix of cases there and then at ten dental restorative general dentists. So a combination of things that practice is full service. So it’d be working alongside specialist plan sometimes working alongside Martin’s plans which can be quite complex. It’s a very. Edifying [00:31:00] experiences across the three and working alongside people with different approaches and finding which parts you want to take into your clinical practice is what forms you as a clinician. And I think I said it in my post for accreditation, you’re usually the sum total of the people who have exposed you to their workflow. Yeah, yeah. And sometimes we forget who those people are, but they will have had an impact. And you know, I made my list.

Speaker3: It is a long list of people I saw there.

Speaker4: Yeah.

Speaker1: So when I sat [00:31:30] down and I thought, who has impacted my practice in a significant way, that I remember something that they’ve taught me and I made that list. And, and it’s a very earnest list because there are tangible things they’ve all given me and I do to this day.

Speaker3: And so let’s pick up on I mean, yeah, clinically, all of these guys are different. Let’s pick up one on the other side of it, because you now are a practice owner yourself. What are things you learnt regarding patients, staff on the practice [00:32:00] management from these three different characters through these three different.

Speaker4: Places on the.

Speaker1: Non-clinical side?

Speaker4: Yeah, we’ll get to clinical.

Speaker1: I had a mentor of sorts. My name is Jill and she isn’t a dentist. You could say she’s a practice manager treatment coordinator, but I’d say she’s much more than that. She’s been at London Smile Clinic, I believe dentists before that and Welbeck Clinic after that and then Harley Street Smile after that. She’s had experience across the top cosmetic clinicians across her career, and [00:32:30] she has enough knowledge to be a dentist, pretty much, and to look at things like a dentist would. But from a customer service point of view, she imparted a few things as to how to make how to make a procedure that is expensive, not very comfortable, as easy as possible for someone who is anxious. We don’t get taught that at university. So specifically I learnt how to respond to complaints, which they don’t teach, how to read someone’s personality as to what they’re really upset about. Sometimes [00:33:00] it’s not written down for you to actually unpick. You have to read between the lines, and how you respond will dictate the outcome in many ways, not from a litigation or a regulatory point of view, but from.

Speaker4: Patient management.

Speaker1: Patient management, patient expectation and the goodwill of the practice. And that goes a long way.

Speaker4: So just just to drill.

Speaker3: Into that, it’s kind of that question of why are you trying to fix it now kind of question, isn’t it, where someone might say, well, [00:33:30] I’m going to get married or I’m I’m at a stage in my life where I’m not feeling like so understanding these sort of soft things around.

Speaker4: That’s right.

Speaker1: Yeah. So I think why fix it now is probably an Ashley lattice sort of. Is it probably. Yeah. Something that he would say is, you know, drill down into what is the motivation to do it now. Yeah. And with a complaint letter it’s a similar approach. What are they actually concerned about. It may not be verbalised. And sometimes you have [00:34:00] to bring them in and just have a have a conversation over a cup of coffee and try and understand how to fix things and finding out what the different routes are to to fix things. And with cosmetics, it’s slightly different to health orientated treatments because the complications are more to do with dissatisfaction over aesthetics or a miscommunication of what the intended outcome could be. And this is not this is a very fine margin stuff. This is these are, you know, as well as I do, the types of things we can be asked for would not [00:34:30] be noticeable by the majority of the population, but it’s important for that person. So understanding that person exceptionally well, the outset is important. And I think, you know, I’d credit her and the other two clinics of giving me that kind of rounded approach as to how to take feedback from a patient in a way that can positively be spun into a way to move forward. You can’t always fix it so.

Speaker4: You know when you can’t.

Speaker3: So now you’re a bit more seasoned. Yeah. Are you almost looking for that nugget [00:35:00] to feed back to the patient? Almost like it’s such a long time since I’ve done a dental examination. But but now that you’re saying it this way, I mean, people are kind of pre-qualified. By the time they come to you. They’re already talking about a makeover of sorts, I suppose. Right. So then you’re almost in, in the, in the assessment process, looking for that key that’s going to sort of switch them into fully trusting you. Is that.

Speaker4: Right? Yeah.

Speaker1: I try not to [00:35:30] prejudge anything. I try and keep an open mind. So even though we’ve got data from them sending their first inquiry or referral into the practice, my treatment coordinator may give me some information about what she thinks about the patient. I’ll take that and I’ll park it. We’ll put it into a note. But when the patient comes in, I really just want to give them a clean slate and just let them tell me about themselves. I want to listen. And another thing I learned from Jane Sproson, you know, is first listen. To understand, [00:36:00] then respond. Dentists have a great ability to pre-empt what someone’s going to say to us, because we know if they give us this list of symptoms, it’s irreversible. Pulpitis so we just know what we’re going to say. You need a root canal treatment. Et cetera. Et cetera, et cetera. I try and disengage my brain from that. Just let them tell us where they’re at. It might be simple. It might be complex. And if those nuggets come up at that time. Okay, hold them in your mind and talk to them about that later, or use it to progress the plan.

Speaker3: But, [00:36:30] I mean, I spoke to Basil Mizrahi and he told me, look, the kind of treatments that I end up doing for patients are so involved. They take such a long time, and they cost such a lot of money that it sometimes takes him three assessments before he’ll want to go ahead on that patient. So do you ever do that? Do you ever get them back in again or what’s the what’s the patient journey. [00:37:00] Let’s go into it. What’s as far as the patient’s met you. You’ve had the chat. You’ve had a look.

Speaker1: One thing I’ve missed out is before the patient sees us in person, there may be a video call. Oh, really? Okay. Video call with myself or the treatment coordinator will uncover many of the things there. And when we go into our consultation phase, we’re doing a barrage of data collection, photographs, occlusal analysis. And then if it’s a complex plan, such as the ones you mentioned Basil might be involved with, I [00:37:30] would give them a skeleton framework to work with. One thing I’m hesitant to do is to give them no plan and say, really? Well, we need to get you back to study models and do a wax up, which I know is an approach that some specialists take. And I think in today’s world, people want to be sure that there is a solution here, and I try and give them that. And sometimes it means that I have to give a treatment plan. That is. Yes, it’s an estimate, but I’m held to it and I give it as accurately as I can. I may refine it later with the second visit. So [00:38:00] to answer your question, in a complex plan, I would do the consultation.

Speaker1: In most cases, 90% of cases I will know the broad strokes of the treatment plan. What I might not know is what’s underneath some of these restorations. I might not know if I can identify this implant, if I can uncover and dismantle this implant in. There are several cases that come to mind right now, but that doesn’t stop me. Treatment planning for every eventuality, I can give the patient a couple of options and say we may not need both. It may just need one. We will find out later. And patients [00:38:30] normally understand. And the other one is we don’t have a cbct in front of us. I can’t tell you if you need a bone augmentation, soft tissue augmentation just yet. We may need to ask you to see our surgeon. And it doesn’t stop me giving them a prosthetic plan. There just may be bits added later, and I just try and communicate that clearly and people seem to understand. So the first consultation is top heavy. Give them all the information then and refinements later with Basil’s approach. You mentioned of a three stages. I can’t comment specifically, [00:39:00] but horses for courses?

Speaker4: Yeah, yeah.

Speaker3: So just fill in the patient journey for me a little bit. Typically, what’s the most typical route by which a patient finds you? Word of mouth or social media or.

Speaker4: Google okay Google.

Speaker3: So you’ve got a good Google game to start.

Speaker4: We’ll give it a try. Yeah.

Speaker1: I think the difference with Google people are actively searching for something. So they’re usually quite they’ve done some research [00:39:30] attention. Yeah. They’ve got some Dental intelligence. And when they come in they actually they’re engaged. So that’s the most common.

Speaker3: So okay the email comes in or something.

Speaker1: Email comes in, we ask for a photo normally and maybe a 1 or 2 concerns they might have. And the photos may range from lots of photos to no photos to a video. And based on that, our practice manager who clinically trained and we’ve worked together for many years, she analyses the photo, gives her best guess as to what she thinks. I would [00:40:00] say she may run it past me before she writes a response. She would give some indication to the patient as to what she feels could be an option. And if it’s something not so straightforward, such as something involving tooth replacement or ceramics, she would suggest a video call with myself. We arrange a video call. I try to glean more information from a video, which usually is helpful but limiting, and the next stage is a in-person consultation. So from there, we’ve had three touchpoints of consent, I’d say, [00:40:30] which I think is really important because sometimes the consent forms we give are so verbose and so detailed that no one could absorb that much information. I wouldn’t I wouldn’t read it quite right. So when they come to the clinic in person, they already know a lot of the disadvantages and advantages of, let’s say, implants versus bridges or ceramics versus composites. So when I have that discussion with a photograph and a radiograph in front of us, they can actually engage and understand what I’m telling them. After our data collection, [00:41:00] I would issue a treatment plan based on what they think is good for them. And if they’re not sure, I might issue two two treatment plans if they’re thinking of both.

Speaker3: But when? So how far? When does that appear? When does that land? Is it at the end of that visit? Is it one day later?

Speaker1: Is it on the day?

Speaker4: On the day?

Speaker3: Okay. Perfect. Because you’ve had these touch points. You kind of know which way which direction you’re going.

Speaker1: Yes. And I try and give my advice as well because many, many people will defer to us even though we are. Supposed [00:41:30] to give the options and the patient makes their decision. Yes, they do, but they may ask us for what their advice is, what our advice is, and I.

Speaker3: Yeah, and I think Prav talks about this a lot, and I totally agree with him that in that moment. We should give the answer, we.

Speaker1: Should.

Speaker3: Whereas that’s not specifically taught. I mean, there’s a lot of people who say you give them the three options. It’s their decision, you know, but, you know, with every other supplier I’ve ever had, right? [00:42:00] I’m going to ask that supplier, okay. What would you do in this situation yourself?

Speaker4: It’s so interesting.

Speaker1: Ollie Harmon and I were discussing this at accreditation. Viva. Oh, really? Yeah. Because there was a case which I did, which was very debateable as to which approach to take. And we were having the debate open forum, three examiners and the ten of the accredited members at the back of the room listening in. And we were.

Speaker4: Let’s be nerve wracking.

Speaker1: It was it was when you have that much knowledge in the room to temper my answers very carefully.

Speaker4: Choose your words.

Speaker1: Not as much as I have today. And [00:42:30] we were asking ourselves the question, to what extent do we respect the patient’s autonomy to make a bad decision?

Speaker3: Well, if they have informed consent, right?

Speaker4: Correct.

Speaker1: Informed, informed consent. But there must come a line where we are no longer comfortable to actually do the procedure ourselves. So we have patients. Let me give you an extreme example.

Speaker4: Oh, I get it. I get the.

Speaker1: Extreme. One is a patient comes in and says, I’d like to have all my teeth removed in favour of implants. You could give them informed consent and they [00:43:00] may still continue with that decision. But how many dentists would be comfortable actually physically doing that procedure? Not many. So there comes a line where a dentist would not be willing to cut a tooth back, or to remove a tooth for reasons of elective informed consent.

Speaker3: But but I mean, just in that it’s an extreme example, right? But if you thought you explained to the patient the benefits, the costs and benefits and advantages and many disadvantages of that [00:43:30] route of action, and then they they said, yeah, I hear all that, I understand all that, and I still want to have my teeth taken out. Then you need to refer them to some sort of psychologist to see. Are they, are they actually understanding something like that? It’s madness.

Speaker4: But yes.

Speaker1: But also don’t underestimate people’s ability to make a bad decision and to have a different set of values that we may do as dentists. We’ve been through a very specific training pathway [00:44:00] to understand dental health, medical health. We have that information that patients do not. They also may have different set of values in the sense of I’ve seen people be prepared to take much more physical risk with the aim to get 10% of aesthetic improvement, whereas they may never do.

Speaker4: It came up in.

Speaker3: Dental trauma, didn’t it? We both.

Speaker4: We both. Yeah. You were there.

Speaker3: Both. We both commented on it. Yeah we.

Speaker4: Did. Yeah.

Speaker3: You’re right, you’re right. It’s an interesting it’s an interesting area. Right. And that daughter test that came up. Yeah there’s there’s sort of it’s [00:44:30] the daughter’s choice.

Speaker4: That’s right. It’s not your choice. Well the point.

Speaker1: The one in Dental Rama. I didn’t explain too well. Maybe I can explain it here. Yeah. The daughter test is problematic because the act of the patient being the daughter is not what should guide your decision making. It has to be the patient’s values and circumstances in their personal, professional and social life, not the fact that they are a loved one of yours. Yeah.

Speaker4: Agreed.

Speaker1: So Martin Kelleher had an unfortunate experience of having his career exposed with lots [00:45:00] of ceramics cases that got complicated, and he had to replace all of them. So he published the articles that he that he published and Daughter Test was one of them. And that article is infiltrated all dental schools. And that’s now how we make decisions. But I’m keen to write a response to it, to say that we need to come away from the daughter test in favour of something along the lines of Montgomery’s judgement, which is to take into account the patient’s values in that point in time informed consent, as you said, and [00:45:30] respect their autonomy to make a decision you don’t agree with. Yeah.

Speaker4: Agreed?

Speaker3: Agreed. Like, for instance, if, let’s say the person is a model. And is thinking career wise, this will help my career loads and I accept the health cost for it.

Speaker4: I would be much more that they’ve.

Speaker3: Got agency in that decision.

Speaker4: That’s right.

Speaker1: And your ability to be more aggressive with your treatment plan in the aim of helping the cosmetics should be much broader than someone [00:46:00] who is not in that in that professional work.

Speaker3: That said that said, I think the infiltration of the daughter test into all curriculums probably overall net net, a big positive. It’s a good, good, good thing to keep pointing people to. But you’re right, there’s nuance. There’s nuance especially. You’ve got to understand that in your situation, you’re seeing that the very edge of I mean, I know you understand this, but you’re seeing a very edge of the total. The people who are coming for specifically this sort of treatment. [00:46:30] Talk me through now the rest of your career after that. So you were in these three practices. What was the next career move?

Speaker1: One of the dentists, Harley Street Small Clinic, was departing, and I was asked to do more days there in a hurry. And I had a decision to make whether to say yes and consolidate my time to that one practice, which is what it would take or to decline. And I took the decision to consolidate to one practice at [00:47:00] that point. So that’s what I did. And what.

Speaker3: Was the driver of that decision.

Speaker1: In Hertfordshire in ten Dental? Whilst my exposures to dentistry were excellent and I had a good time, both of those practices, Harley Street Smile was not a general practice. It operates as a little bit like a referral clinic. Patients come to us for their elective treatment and they usually have a GDP they go to afterwards. And I was intrigued by that approach, and I thought it was good in the sense of it allowed us to really become experts [00:47:30] at a very small select group of treatments. So I can tell you what those are. It’s it’s tooth contouring, gum lifts, composite bonding and ceramics implants was my bag. I did a bit of that as well. That was it. It’s a very small group of treatments. And I thought to myself, those are the areas I’m developing most in. I should do more of.

Speaker4: That was all.

Speaker3: Did it? Did it spill over into full mouth rehab, or were you referring those?

Speaker4: It did.

Speaker1: It did a little bit. And depending on different [00:48:00] clinicians risk appetite, people would take it on or not take it on. And that’s where some things would go in Basil’s direction or not. And we had a referral relationship with Basil’s practice at the time. To clarify, it was Maurice Gilmartin and myself, those practices, and Jill’s actually one of the people that pushed me towards accreditation.

Speaker4: Oh, nice. Nice. All right.

Speaker3: So so then at what point did you think I’m going to break out by myself? And did you go all in or did you keep doing a few days circumstances? [00:48:30]

Speaker1: I stayed at Harley Street Smart for five years, so it was quite, quite a big gap between consolidating my time and thinking about starting my own. I think the first inkling of it was when dentex became involved with many of the practices across the country. They struck a deal with Maurice’s practice, and they they took over us. Yeah. And and no particular issues as such. But what did happen was I wondered what happened at the end of that road for dentex. What was the outcome going [00:49:00] to be for the practice? And it was kind of unknown at the time. And I was I was relatively happy. So I was not I was not thinking of starting my own. It wasn’t really on the cards. But I did think to myself, is the long term in anyone’s sort of radar? Dentex. Maurice, what’s what’s their outcome here? I didn’t really know what it was. The thing that tipped it for me was having a regulatory case occur in 2019, and I didn’t know what the outcome of that would be. The two outcomes were I [00:49:30] stay at the current practice or I need to start my own for reasons of being let go of that practice as a result of the case, and I didn’t know what it would be.

Speaker3: So you started mentally thinking, worst case, I’m moving. But you weren’t moving to an associate somewhere. You were going to move and do your own place.

Speaker4: I also considered.

Speaker1: Moving as an associate as well. When the case did break out publicly, I did get a lot of calls of support, and people did actually say to me, if you if you need a position, give me a call. Which is really kind, actually [00:50:00] at time was quite difficult, you know, quite difficult time. Having said that, Harley Street Smart were very supportive. They had no intention of.

Speaker4: Letting you go, letting me.

Speaker1: Go. And I give the clinic and all the team a lot of respect for that, for for going through a very tough time with me. But we didn’t know what the outcome of the case was until 18 months after we knew there was a case. So we just continued as normal until that time. And but in my mind, I thought to myself, well, either I stay at this practice or I become an associate or I start my own. Which [00:50:30] one of those was I didn’t know until I knew how long, how much time was going to be suspended for if I was going to be suspended at all. And what the. Fallout would be with the practices involved, because the complicating factor for a business is if a dentist is not there, they can’t leave the position open. It’s not viable. And I totally understand. So how long can a business leave a space for a dentist financially and still have me come back.

Speaker3: To go into the case? Sure.

Speaker1: Plymouth. [00:51:00] What would you like to know?

Speaker4: Tell us about the case.

Speaker1: In a in a nutshell. The case was me not maintaining a professional boundary with a patient combination of poor judgement on my part and bad luck. I think I’ve learned some hard lessons from it. I’ve learnt a lot about our regulators and how the system works. I’ve taken some positives from it as well. I think if the case hadn’t happened, I think I would be at Harley Street. Smile.

Speaker4: Oh really, I think so.

Speaker1: And I wouldn’t [00:51:30] have taken a six month sabbatical ever. I can’t see why I would, but having taken that six months or been given that six months, it was one of the nicest and most memorable times of my life because I legally wasn’t allowed to give any dental advice either. So I had to actually ignore all my emails.

Speaker4: I mean, I love how you’ve.

Speaker3: Drawn a such a positive out of out of that, but take me through the darkest part of that time. So, I mean, do you understand that people say it’s the most stressful time of their life? Did you feel that [00:52:00] or not? Did you manage it differently?

Speaker1: It came in different ways.

Speaker4: Moments.

Speaker1: Yeah, because a case starts at a point in time and only a handful of people know about it. It’s not so stressful at that point. And then it continues on. You don’t really think about it. You continue practising as normal. And that was one of the most supportive things, is that even when the case broke out publicly patients, it didn’t change a thing in the practice, which was encouraging. The most stressful time was, I think, when the [00:52:30] press picked it up and decided to spin it and spread it everywhere. And this was in November 2020. We’re just coming out of Covid at this point and just starting back up. Things are quite busy in dentistry, and I didn’t expect it to get a.

Speaker3: Stressful period for everyone, wasn’t it? Let alone having this on top?

Speaker1: I think so, and we were not expecting it to go national and viral and international. It was more than what we had expected and as a result, that had to have some very difficult conversations with everyone [00:53:00] from other dentists I knew to family to my commanding officer in the Navy, because I hadn’t told people in the Crimson what what was happening. I in broad strokes I may mention it, but I wouldn’t give the details. And that was the toughest time.

Speaker4: You mentioned the.

Speaker3: Navy. Were you a Navy dentist? Were you that cut?

Speaker1: I’m a general entry. I am not Dental in the Navy. Oh. Non dental.

Speaker3: Oh I see. How interesting. So, [00:53:30] okay. Advice to others who are getting that letter because many, many, many of us are getting this letter now that you’ve been through this awful experience. What are your nuggets that you’d advice that you’d give others who are going to get these letters?

Speaker1: I have had conversations with people who have had these letters and they ask for advice. And each case is very specific. And me, having been through one to do with professional conduct, is [00:54:00] very specific and many cases are clinical performance related, which is an entirely different arm of the GDC, one that I don’t know about to the point of. The panellists are very different as well. So on the clinical performance ones, I’d say my knowledge is as good as yours, but the ones on professional conduct, I always went into my case trying to be open and honest, and to hold my hands up to what I did wrong and to apologise, seeing in the judgement what has been decided [00:54:30] to be a fact and what’s not a fact. Part of my mind thinks is that which was was my approach correct? Because it didn’t pan out in my favour, and I’m not sure what I could have done to make it any better. I’m not sure. I’m not sure I could have. I could have made it worse. And I think probably being candid and honest is probably a good way to go.

Speaker3: Yeah, I can see. Look, just talking to you, I can see you’re choosing every word very carefully. Not just about this. On every subject I see, you know, any, [00:55:00] any point you’re. I can see honesty is a massive thing to you. It seems. It seems obvious. But when I’ve been involved with a legal problem before. Nothing to do with dentistry but a legal problem, which it was dentistry. It wasn’t. It wasn’t GDC. Um, I was shocked at how the system didn’t just bring the truth out. I thought, you know, in my naivety, I thought, look, I’ll just tell my side of the story. The truth will out and [00:55:30] that will be the end of it, and it doesn’t. Whereas my adversary had loads of experience in legal and played that experience really well and didn’t necessarily tell the full truth, and mud stuck. So so, you know, this question of could you have done something differently in that case, I don’t know. I don’t know because I’m not expert. But I was shocked, I don’t know, how did you feel about number one, the legal ramifications, because, you know, before you were ever involved [00:56:00] in anything legal, you just think, well, it’s just it’s just this wonderful place where the truth comes out. But that certainly isn’t the case. It’s a place where the best lawyer is wins, is what I found out, like the one, the most expensive lawyer. But but number one. But then number two.

Speaker4: Most compelling lawyer.

Speaker3: Compelling.

Speaker4: Compelling. Aggressive. Compelling. Yeah.

Speaker1: Verbose.

Speaker3: Yeah. Number two. What about the press? Did that surprise you as well? I mean, what were the what were the the [00:56:30] ingredients of that virality? Was there was there someone in the press that acted outside of what you would have expected or what? Did it just go viral because it did or salaciously what was it, what what are what are your reflections on the law and the press after having been through this?

Speaker1: Interestingly, with the press, I thought if we ever did a PR campaign to get some positive press on myself post the case, would they ever would they ever do this? Because I’m sure, you know, [00:57:00] if you have the, let’s say, the Daily Mail and they have an article about you and you say, okay, let’s do a, let’s do a piece about dental health education. And they may just link related articles about me at the bottom of that, which spins the old negative press at the same time. So my team and I were really worried when we launched the practice as to how can we launch a PR campaign without risking the negative press getting resurged. Encouragingly, we found out that the press are not personal. They [00:57:30] really are not. They are business entities that are looking to.

Speaker3: Driven by their own goals, driven.

Speaker1: By other goals. Bigger than you, bigger than me. They do not particularly care about the case or even about the the truth element you mentioned. So when we decided to do a PR campaign to the positive, The Sun, the Daily Mail didn’t spin anything from the past and as a result I learnt something about it. So that was what I learnt about the press. And when it comes to legal matters, it’s, you know, circling [00:58:00] back to your very first point about your case and you truth not necessarily coming out. I think when it comes to things that don’t have hard evidence, when it’s your word against someone else’s, humans are going to be humans. And I’ve learned that that is the case of panellists as well. It’s not that they’re trying to make it hard for you or have someone else’s side necessarily. They’re going to be guided by human factors, how you come across in cross-examination and in hindsight, I didn’t come across so [00:58:30] well in cross-examination because I was under extreme pressure and extremely stress. So as a result, it became very sort of robotic in my answers, which didn’t come across well.

Speaker4: I mean, you.

Speaker3: Started the clinic, you went for some positive PR when you say you went for PR, did you hire a PR agency? Yeah. And then I mean, look at now I look at your social media, you’ve got many, many thousands of followers and your output is extraordinary. Were you doing [00:59:00] that? From what point was it, was it was it when you opened the clinic that you went ballistic on the social media, or were you already doing a lot? Was it was it kind of a redemption thing where you wanted to just say, hey, I’m, I’m out here and I’m, I don’t I’m not I’m not shy after that that’s happened, you know, how did how did it how did you feel about it? All of.

Speaker4: The above.

Speaker1: I remember speaking to a friend at the time and thinking, I post clinical cases like many dentists do. Yeah. [00:59:30] Before and after. Pretty mundane these days. But not a lot of people go on camera and talk about things. A handful of people do as we know. And I thought, can I add anything? And I kind of really racked my brain. An offer, put some ideas down and started recording some stuff. I just thought, I’ll upload it, see what happens. Then I got some traction on it and then it continued. And that’s really it. Redemption. I don’t think of it like that because I had such a rich time in that six month period. I don’t think of it as like a negative in [01:00:00] my mind. It’s actually a time I really relished and I had such a great time travelling. I know we talked about it when I was away. It’s such a positive in my life now. All the things to do with the case just almost kind of gets, you know, cornered into nothing. And, you know, the time I’ve spoken about it, today is the first time I’ve spoken about it in a long time.

Speaker3: Did you come here today planning to speak about it or did you? When I asked you this morning, did you decide there and then? You’re. You’re cool.

Speaker1: Given the subjects you’ve brought up on [01:00:30] this podcast before, I thought it would be on the cards. I didn’t know if you’d actually do it, though.

Speaker3: It’s incredibly brave. Incredibly brave of you to to be happy to talk about it, because you can understand why someone would want to sweep this under the carpet, but also incredibly helpful to others. And then, from my perspective, incredibly impressive what you’ve done with it. You’ve sort of used it to propel yourself forward in a way, you know, as a as a driver that you’re going to prove us all wrong or [01:01:00] prove whoever was was saying anything about you wrong. Something like that. And what kind of a person are you, dude? Are you are you the kind of person who gets involved in back and go up the the, you know, what do you call it? The committee and.

Speaker4: I do.

Speaker3: That sort of.

Speaker4: Thing.

Speaker1: People usually go committee or accreditation way. I’ve chosen the latter.

Speaker4: Yeah.

Speaker1: So I think I’ll continue on that. On the education side, I do enjoy passing on what I’ve learnt because so many people, as we talked about, you know, passed on what they, [01:01:30] they, they learnt. And I’m doing a bit more teaching with the, with a little bit more with, with other teaching academies as well. And that kind of blends in quite nicely with the oral health education for the public, which is on social media. So I quite like just getting better information out there, because one of the things I find is misinformation is problematic, and the industry in the UK is lagging behind mainland Europe and the rest of the world in terms of clinical standards, but also knowledge. So I’m [01:02:00] trying to change that for the public and dentists.

Speaker3: I’m going to ask you a really, really unfair question now. Yeah, but I kind of like this idea, right. Of if you had to put it in a nutshell, your clinical not value add, but your clinical aha moment, what would that be? And let me give you an example. When I asked Sam Jethwa this question, he gave a lovely answer. It was about the occlusion being outside in as well as [01:02:30] inside out.

Speaker4: Oh really? That was his when.

Speaker3: When he when that clicked for him, it it made a big difference. And it was funny because at the time I’d never thought about the outside. So I’m sure you had but but I had. Can you think of, like what comes to mind when I say that?

Speaker4: Yeah.

Speaker1: Occlusion comes to.

Speaker4: Mind because it’s.

Speaker1: An area which, you know, shrouded in mystery. And Sam and I kind of went through a kind of together. Almost together. Yeah, a journey on that. But we never spoke about it too much because clearly we have different experiences. But a big [01:03:00] thing in my mind and other people’s minds. How can you fit a restoration and know if it’s going to last with confidence? As a dentist, you’re coming out of dental school. How can you know it’s going to last? What are the parameters that we should check aside from? You know, how the teeth come together? That’s just not enough. And I think the aha moment is understanding guidance, pathways, steepness, interferences, how people posture their teeth. If there is interferences, how [01:03:30] that gets deflected to other teeth. It’s a very generalised way of saying why things break down and you look at enough cases and look it in a certain way and you realise why things have worn in a certain way, why that cusp is broken. Once you realise that you can treatment plan so much clearly so.

Speaker3: So again we are talking occlusion.

Speaker1: Talking occlusion. Yeah.

Speaker3: But give me an example. Like it’s often, it’s often the lateral that’s broken okay.

Speaker4: Here’s here’s one. Have you ever.

Speaker1: Seen you have seen those cases where patients got no worn teeth [01:04:00] at all except the lower anteriors. We wonder why. Okay, they’re clearly posturing on those front teeth. Right. What’s what’s up with that? And I found out why. Constricted chewing envelope. Class two, Division two. Retrogradation of the upper central incisors. Creates less space for those lower incisors in function. As a result, you get that shearing effect. You get that incisor buckle where that shiny surface, and you multiply that over 20 years. What do you get? You get localised anterior tooth [01:04:30] wear. These cases are primed for a certain approach to be treated. But that was a clear moment of now I can see all those cases. As soon as you see that you know exactly what’s going on. And before you would think, oh, well, there are attrition. It’s. And it’s not just that.

Speaker4: You doll.

Speaker3: Do you doll as well or not?

Speaker1: I do, and I’m developing or formulating a slightly different approach on doll, which is what I’d call accelerated doll. Typically doll is with the cobalt chrome appliance onto the top teeth. You get the [01:05:00] space built up through that way, and then you restore them indirectly or directly. I think Hemmings then developed that process to have doll direct composite build-ups, which is now the preferred approach instead of the appliance. So I’ve taken that one step further and I take it to ceramics instead of composites. Increase video, and I’d hope to publish it at some point. But if you direct the forces in a certain way, the intrusion and extrusion effects you have will not compromise your aesthetics. [01:05:30] That’s the main concern, and I’ve.

Speaker4: Got pretty good.

Speaker1: Recall. It’s fine.

Speaker3: The other thing Sam said was his sort of value add was, if I remember correctly, the temper ization phase where he thought he had a pretty could give the patient a very accurate representation of what their final result was going to be with his temporaries, even though I think he doesn’t directly not not in that sort of Gallup career way. What would you say? It’s your sort.

Speaker4: Of.

Speaker3: Value [01:06:00] add if I if a patient comes to you specifically for aesthetics, what is it that you do that adds value? You know, it’s an interesting question because in a way I’m asking for, okay, you’re standing on the shoulder of giants. There’s all these people who’ve given you tips. What’s your tip? You know, your tip that you’ve come up with? I know you’ve got many.

Speaker1: My approach to understanding ceramics as they are today, I think I go a little bit [01:06:30] deeper than most would. Ceramics are developing very fast, and one of the things that have eluded most ceramics cases is getting fluorescence on the result. Now, if people are wondering what that means is when light goes through a natural tooth, it internally refracts in the dentine and then emits back out as if it is its own light source, and that gives the appearance of vitality. So what makes something look less flat? Emacs Press has always had a problem with [01:07:00] this because it looks grey at high value, right? And it has quite low fluorescence, but it’s a great material because of biomechanical properties. Feldspathic porcelain is awesome for a fluorescence because it’s got so much natural feldspar in it that that internal refraction can be emulated. But it’s got biomechanical issues, right? Super weak, and you need to cut heavy margins. All this stuff is it doesn’t really fit with minimally invasive dentistry. And you can’t you can’t do it. Accelerated [01:07:30] dull and feldspathic ceramics. I wouldn’t advise it anyway. Ceramics are developing. There are ceramics out there and I would say my tip and my my value add is understanding those ceramics, knowing which combinations work best. I keep a list of my ceramics and I are aware of which combinations will work best for different skin tones, different types of makeup, different lighting and that is what will make a nice looking smile, smile, make over look sort of world class versus, you know, kind of just really good. [01:08:00]

Speaker3: Now I’m really interested in if there was a way of doing an experiment. If I removed your ceramist from you, how long would it take you to get back to where you are now? And vice versa, if we remove you. Yeah. And there’s a ceramist working with another dentist. What would be the situation, how long it would take him to get back to?

Speaker4: I’m glad you.

Speaker1: Asked that, because I can answer your question. I can.

Speaker4: Answer I can answer.

Speaker1: The first one anyway, if I get removed.

Speaker4: I’m not sure. That as well.

Speaker1: The [01:08:30] first one. If the ceramics gets removed, how long does it take to train a new ceramist to the same workflow? Six months.

Speaker4: Six months.

Speaker3: And that’s someone who starts already. Quite good, right?

Speaker4: Yeah.

Speaker1: Someone who’s free thinking, creative, good at their hands. Quite a long time.

Speaker3: Yeah yeah yeah yeah yeah for sure.

Speaker1: And that’s why I would always advise people doing a lot of ceramics cases to have multiple ceramists, because 1st May go on go off sick or something will happen. [01:09:00] And you need, you need several. And usually ceramics are not good at everything. So an occlusion doll case is going to be someone very technically minded, not necessarily creatively minded, versus a single tooth ceramic case. You need to have, you know, a really careful.

Speaker3: Chairman versus an Italian.

Speaker4: That’s right, that’s right.

Speaker1: So German Swiss approach would be very, very. Yeah. And okay, so the typical one a lot of South African ceramics in the UK, they are very good with occlusion and things like that. But [01:09:30] creatively they all have one way of making teeth look and that’s it. And that and one of the Holy Grail in ceramic work is for ceramists, is having creative diversity in how you build teeth. We get taught how to build a tooth and we make it the same way each time. Having variation is one of the hardest things. I’ve only ever seen it a couple of times and if you get it, those people are worth their weight in gold.

Speaker3: Let’s move on to darker days, even darker. I know we’ve [01:10:00] been through some, but we like to on this. On this pod, we’d like to discuss errors so that in medical we we don’t have to share our errors very much, mainly because we’re sort of trying to run away from blame. But it’s based on black box thinking where if there’s a plane crash. The community tries to find out what happened without blame, and then the information goes out to the whole community so [01:10:30] that you don’t have to learn only from your own mistakes. You can learn from other people’s mistakes. With that in mind, and outside of your case, what comes to mind? Clinical error wise.

Speaker1: The one that comes to mind was in my last couple of months as a foundation dentist, I was on a steep learning curve. As we discussed. I was keen to, you know, they say after a course patient who’s most in need of that treatment is on Monday, right? And I was succumbing to that as well. [01:11:00] I thought I’d take on a full mouth rehabilitation case in ceramic, and at the time I was working alongside a ceramist who was very high achieving as well, and was working at a high standard. So the pressure was on, you know, in various various ways. It was prosthodontic. It was it was it was quite complex collusion and my knowledge was definitely lacking. And the issues that came out of the case was that I didn’t know enough about how to take [01:11:30] complicated impression of multiple abutments, to the extent that I could never get a good working model. So as a result, the restorations never fit perfectly. And this is a combination of bridge crown on veneer. So you’re asking the to go into different nooks and crannies and directions. And as soon as you have that you often need to take to use other methods. And I and I couldn’t get my head around it. And I also had a limitation in terms of the standard of materials I was working with. Now they say they don’t, you know, don’t blame your tools. [01:12:00] To an extent you should for sure. And with one of the things that I realised as soon as I went to a practice with something that was a high standard material, wow, my technique or the material seemed to make a big difference. It probably was both.

Speaker3: I mean, listen, imagine if I took away your favourite instrument or your favourite loops or your favourite composite, or you would affect you, it would affect you.

Speaker4: You give me a.

Speaker1: Turbine instead of a speed increasing handpiece, I’ll be there for a [01:12:30] lot longer. And the burr is going to do this. You know, it doesn’t matter how steady your hands are, the burr is doing this.

Speaker3: So go ahead. Go. What happened?

Speaker1: So the case, the case I was up against the clock because I was leaving to go back to London, and I was aware that I wanted to finish the case. It’s not really one you can pass on to someone else. The good thing is about the case is that it was pretty much as a Df1 any private work you do, you are not paid for. So it’s pro bono from my point of view. For me, I just wanted to learn. And, you know, as a result, the patient gets a huge discount [01:13:00] on the treatment. The case was was fitted. The margins were incongruous, not not fitting as well as they needed to be. And I’m thankful to my trainer for taking on the case and redoing it, which is what I believe happened.

Speaker3: So the mistake.

Speaker4: Was a disaster.

Speaker1: There was no disaster that.

Speaker4: You know, what.

Speaker3: Was the mistake? You didn’t know how to take the impression with a special tray or something.

Speaker1: Oh, I had all of that. Yeah.

Speaker4: What was the mistake?

Speaker1: Not understanding the complexity of how to prepare for restorations [01:13:30] of different shapes around the arch. How to transfer the relationship when you’re preparing upper and lower teeth. I was going to learn that about six months from that point, and I wish I knew that before that. So the lesson I took was probably to not jump ahead too fast. It’s hard to know where to where to pitch it, because in many cases, you know, that was smaller than that. You know, they worked worked out really well. How do you know when it’s too much or be beyond your scope? It [01:14:00] clearly was took a lot from it, and I think it was a safe environment to do so because the patient was not, you know, had a significant discount on the treatment. I was working under two trainers who were very experienced, and the only problem was it was just a combination of limited time, limited knowledge.

Speaker4: Perfect storm. Yeah.

Speaker1: Yeah. And if I had more time, I probably would have fixed it. But but I was lacking knowledge for sure. And I was biting off more than I could chew. And as a result, you know, ceramist is frustrated, team are frustrated. [01:14:30] The trainers are frustrated because I’ve then left the practice and you know, it did haunt me a little bit when I was back in London thinking, you know, you’ve left this, you’ve left this case knowingly in a bad state.

Speaker3: And we never know, do we, until we try something for the first time. We never know what the outcome of that is going to be. I remember my first cerec was horrible with all the powder.

Speaker1: Yeah, I use powder.

Speaker4: Yeah, yeah, I remember.

Speaker3: My first Invisalign. I could not believe that they were letting me loose on a patient with a two day course on [01:15:00] how to use the the portal, you know? Yeah. At the time, Invisalign was quite a hard thing to put in place and take out and all that.

Speaker4: So yeah, but I think, like.

Speaker1: You say, the black box thinking approach is lost in health care. Yeah. Why is it lost? I remember writing a reference to Black box thinking in my reflection for the GDC. Don’t know if they they read that part, but.

Speaker4: It’s.

Speaker1: Something that we could take a lot of lessons from that industry, and it would [01:15:30] reduce a lot of the issues people have when they have litigation regulatory cases, by not encouraging them to hide. Many of the typical pieces of advice are came up in Dental AMAs. Don’t change the notes. Don’t try and cover up anything that’s happened. Be be candid. And why is it that people are thinking about covering things up in the first place? You’d think because there’s a there’s a blame culture. There’s the clinician is is liable. [01:16:00] The buck ends with that person. So it creates this culture of people not wanting to own up to mistakes. Which is why I’m glad you asked this question. So what is the mistake? Many people would just never talk about it. You know, how many study clubs have you been to where they talk about failures only? None. None.

Speaker4: You know, I was thinking, Emily.

Speaker1: Rena and I, you know, we run a study club and we’ve talked about it for years doing a study club just on our failures. And we just, you know, we said, oh, no, we’ll do that another time.

Speaker4: Another time.

Speaker3: I’m thinking of doing a conference on failures. Only [01:16:30] failures allowed. Yeah. You call it something fun.

Speaker1: There are two ways that can go, though. Either someone comes up with a real failure, or they come up with a case that actually is awesome. They say, oh no, this is not quite right, and it’s almost like a show off. It’s like a.

Speaker4: Humblebrag.

Speaker1: Exactly. It makes you seem even better because you think failure is this awesome case and it makes everyone feel worse. So you’ve got to put it as a failure. But don’t mean a I mean a failure in the sense of it’s an unfixable or, you know, a failure.

Speaker4: I hear where you’re coming [01:17:00] from here.

Speaker3: I’ve also had another idea, which I think is a wonderful idea, but what do you think of this? I really want to run this by someone. Yeah. You know, you go to a lecture and the rate at which the lecture is being. You’ve been to so many, right? The rate at which the guy is speaking. And my particular bugbear is this four bulleted points. And these reading the four bulleted points out, you know, maybe putting a bit of detail around each one, but I can read them quicker than you can tell me them. Yeah. [01:17:30] So but if everyone in the audience has a button for more than 50%, press the button. The slide just goes forward. It would be nerve wracking as the lecturer would be horrible, but in the audience it’s really good.

Speaker4: It’s really good. It’s good. That is good. You know, there’s a.

Speaker3: Number of times you just think, okay, okay, we got that move on. It’s such.

Speaker4: A good idea because it allows the people.

Speaker1: Receiving the information to receive at their speed.

Speaker4: Yeah, yeah.

Speaker3: And I’ll tell you the other thing.

Speaker4: And it gives feedback.

Speaker1: To the lecturer.

Speaker4: Of, you know, you’re [01:18:00] rambling.

Speaker3: Yeah. And I’m talking to loads of loads of speakers in my time. Right. And I sometimes hear people say, oh, I filled it out with that. And to me I just see red when when I hear that. Right. Because. What are we doing here? Like wasting each other’s time. Going to fill it out with stuff, you know, like, don’t fill it out, make it a shorter conversation if it’s like that. Yeah.

Speaker1: I’m doing a course for the BCD on ceramics courses that don’t exist on ceramics these days, and I’ve got one day to do [01:18:30] as much as I can. Yeah, it’s the complete opposite approach. I was looking at my slides the other day and thinking.

Speaker4: Editing out which which parts can.

Speaker1: I must keep because I need.

Speaker4: I.

Speaker1: Can’t fit everything in. It’s only one day and that’s the problem we should have.

Speaker4: Exactly.

Speaker1: Not having too, you know, too much time.

Speaker4: Yeah.

Speaker3: You know, like traditionally back in my day it would be like, oh, we’re talking about ceramics. Let’s start with the history of ceramics. Yeah, yeah. But by the way, probably, you know, it makes some sense if we’re talking relating the history to the future and so forth, and the trends happen and so [01:19:00] forth. But come on, man, I think.

Speaker1: Chris, Chris finds a good balance in that. He gives you a, you know, a stack of reading material. Very good. Before before you come in. And it’s your choice whether you read it or not. But then he’s going to run with it and talk about everything, you know, assuming you’ve read it. And that’s great because you’ve engaged before coming in. And he doesn’t have to recite to you the history of ceramics. He can.

Speaker3: The thing about Crystal is the presentation is not you know, I’ve seen many more beautiful presentations than his. It’s all about the presentation. It’s not I mean, I [01:19:30] know many more charming, funnier. He’s a funny guy. Yeah, but it’s not about his charm. He somehow manages to for me, he manages to to cover depth and breadth to the right amount. You know, you think it’s either depth or breadth, and sometimes it’s too much depth and not enough breadth and sometimes the other way around. But his his proportion ratio of depth to breadth is perfect.

Speaker4: I think people appreciate his common.

Speaker3: Sense sort of.

Speaker4: Degree [01:20:00] of.

Speaker1: Rationality when it comes to different approaches. You know, you ask him about any, any subject or any teacher and he’ll he’ll give you a very measured response.

Speaker4: Yeah.

Speaker1: He’s not one to get on a bandwagon or fleetingly move from, you know, from, from one approach to something else. You know, as I was chatting to him the other night about biomimetics and, you know, that’s that’s all the rage right now, he’ll come up with an answer which is, you know, quite sympathetic to everything. And but he’ll he’ll give his opinion.

Speaker4: Yeah. Yeah.

Speaker3: But a lot of respect for him. We’re coming to the end of our [01:20:30] time. We tend to end these with the same two questions. The first is a frivolous one fantasy dinner party. Three guests, dead or alive. Who would you want to have a chat to?

Speaker1: First one is straightforward Arnold Schwarzenegger.

Speaker4: Arnie. Yeah.

Speaker3: I had him recently on politics. Do you ever listen to. Yes. Yeah. Leaders leading. Leading. Yeah. I never I never used to understand anything about Arnie until Prav [01:21:00] told me. He’s he’s one of his heroes. And I thought, man. And then I really enjoyed listening to him though.

Speaker1: People think of him, you know, he’s misunderstood as being the kind of the movie guy or the weights guy. But behind all of that, he’s someone who’s kind of he’s lived three lifetimes when one person would be happy just with one third of what he’s done. And all of that is testament not to kind of good luck or anything like that. He’s forged it out of nothing.

Speaker4: Yeah.

Speaker1: So I have a lot of respect for someone like that. And he’s had his fair share of turbulent times [01:21:30] as well. And he’s come out of it and he’s he’s an interesting character for sure.

Speaker3: Didn’t he father a child with his nanny? That’s right.

Speaker4: I think a year.

Speaker1: Or two before he became governor.

Speaker4: Exactly. Yeah, exactly. Who else?

Speaker3: Michael Jackson for the dancing.

Speaker4: Yeah.

Speaker1: And I think creatively, you know, dancing wise, but creatively, you know, think about the best performance in the world right now. He still seems to stand on their shoulders. I know many people. You know, Beyonce is probably one [01:22:00] of the best these days. But you take into account his musicality, his acting ability, his dancing ability. It kind of he did things which very rarely happen, and he developed from his dance style, a whole range of different things in dance kind of developed and it kind of came the roads led from him and.

Speaker4: So, so listen.

Speaker3: I’m no expert in dance, but you are. Yeah. So. Okay. Michael Jackson dance. What about, like, proper professional dancers? That’s all they do. Dancers do they are they [01:22:30] not more impressive than Michael Jackson’s dancing?

Speaker4: No, really.

Speaker3: Because, I mean, his style was his style.

Speaker4: You’re right.

Speaker1: Michael Jackson’s ability in dance was in succession of of professional dancers. And where he where he shines a lot is his ability to develop innovative choreography, which people have not seen before. And he, you know, he developed certain certain dance moves which are very famous now. But branching from that, you had different dance styles. That whole style would come from, from Michael Jackson.

Speaker3: I guess the reason [01:23:00] I’m pushing back is because I was a massive Prince fan and Prince at the time. It was either one or the other.

Speaker4: Yeah, no. Fair enough, fair enough.

Speaker1: When when you had his final concert, a lot of his backing dancers who he chose were some of the best. Dance in the world and remember seeing the interviews of them. Then one of their all of their biggest influences was always him, because maybe because of their age.

Speaker3: But he definitely was special.

Speaker4: They said that. Yeah, an.

Speaker1: Influence on on on dance and also the music that he’s come out with. You think about his like three main albums [01:23:30] musically. Pretty impressive.

Speaker4: Yeah.

Speaker3: But but there was no Billie Jean.

Speaker4: We’ve got to think back to there was no kid.

Speaker3: Yeah, there was no one who ever told him. Beat it. None of this stuff ever happened. Yeah, for me, it was like comic book stuff. Whereas with Prince, yeah, I felt like everything happened to him that he sang about. Yeah, there was an authenticity. But by the way, pop is pop. Pop is not supposed to be about about authentic stuff. So. So [01:24:00] I get.

Speaker4: It. It’s a bit like.

Speaker1: Watching a movie, you know, the movie is fiction doesn’t need to happen to the past.

Speaker4: It’s just, can they.

Speaker1: Transport you somewhere.

Speaker4: Somewhere.

Speaker1: And show you a little glimpse into something and can you believe it? And if you can do that, that’s cool. You know, like thriller and bad to the kind of best music videos probably ever made. Yeah. And you watch them back today and they still stand up. Still good. I mean, from the 80s they stand up. That’s incredible stuff. Stuff from the noughties doesn’t stand out right now.

Speaker4: Right.

Speaker1: And who are we at? We’ve got a third person. Third person. Okay. [01:24:30] Steve Jobs I am not a fan of Apple, but I’m a fan of Steve Jobs.

Speaker3: I’m not a fan of Apple.

Speaker1: Not really.

Speaker4: No. You don’t have an Apple phone.

Speaker1: I used to I gave it up for a OnePlus, Google, OnePlus. It’s one.

Speaker4: Plus.

Speaker1: Yeah.

Speaker4: Chinese thing.

Speaker1: Chinese company. Yeah.

Speaker4: What’s better than Apple?

Speaker1: It’s it’s pretty much an exact copy.

Speaker3: Us is not better than that.

Speaker1: No, it just doesn’t restrict you to all the different things you need to do. You have to. You have to use their charger. You have to use their computer. They’re always it’s kind of a bit de-conflicted. [01:25:00]

Speaker4: Steve. Why?

Speaker3: Steve Jobs I.

Speaker1: Think, was very I was very taken aback by his biography from Walter Isaacson.

Speaker4: I read it, I thought.

Speaker1: His his his approach to. His work, and his life was very against the grain and people. Walter paints a picture of him being someone you like, but it’s something you can really hate as well. And I thought to myself at the end of the book, you know, has he done humanity a good service or not? You know, having alienated all these employees [01:25:30] and from a business point of view, you know, take a few lessons from that into my own business as to how far to push. And where not to. It’s slightly different in health care, but he would find solutions for things by pushing people beyond breaking point. And I think we need people like that. This needs to be everywhere. But we would not have these products if it wasn’t for him saying to his employer, his programmer and his dev make it happen.

Speaker3: I [01:26:00] think Stanley Kubrick, people talk about him pushing actors beyond the pale, you know, like, and, you know, his.

Speaker4: Movies to tears. Yeah, yeah. Real tears. Actual tears. Yeah.

Speaker1: And they would not he would stand back from the actors and he wouldn’t give them too much direct direction. He would do it through one of his assistant directors. So as a result, he was a slightly feared by the crew. And does that give a better performance? Well, maybe you know, who knows.

Speaker3: The results speak for themselves.

Speaker4: Yeah. I mean.

Speaker1: His films are incredible.

Speaker4: That’s the thing.

Speaker3: Lovely, lovely group.

Speaker1: B, funny, [01:26:30] funny. Dinner.

Speaker4: Yeah, yeah, yeah.

Speaker3: Annie and Michael Jackson. Yeah.

Speaker4: I’m not sure they know.

Speaker1: Or Steve Jobs, maybe I know Steven Schwarzenegger. No. Know each other.

Speaker4: That’s about it.

Speaker3: The final question, then. It’s kind of weird with someone as young as you, but it’s like a deathbed question on your deathbed. All your friends and family and loved ones around you. Three pieces of advice that you’d leave the world with.

Speaker1: My [01:27:00] first one is not short, but can I can I can give it to you. Prioritise being happy and having a lot of fun. We’re in this life for a period of time and things will happen, but our only job really is to be happy and have a lot of fun in my view. So make sure you just prioritise that. Which sounds selfish but actually think it’s important. Number two, I can’t take full credit for, but I think it rings true. Stay [01:27:30] hungry. Which means. Always look to be. To be better or. Look to progress, be it whatever you’re doing. There was a book which analysed the failure of major corporations, and they they found that invariably when the company started to kind of plateau and get comfortable BlackBerry or something, that’s when they get surmounted by another entity which is really pushing themselves and [01:28:00] behaving like they’re very hungry for success or for for whatever it may be. So that would be my second. Did you watch.

Speaker3: The BlackBerry.

Speaker4: Movie? I did, what did you think? Loved it. Yeah, it was good. Really interesting. Charming.

Speaker1: Amazing, amazing film.

Speaker4: The story.

Speaker1: The story as well.

Speaker3: I think in your case though, that stay hungry. I would if I, if someone was asking me about you having now had this conversation, I’d say you’re very curious. Person you know. So stay curious. It’s for you [01:28:30] to have wanted to figure out that cerec machine in dental school. I think a degree of curiosity, you know, for you to start with a blank slate with your patient and just feel what they’re saying. It takes a level of sort of intellectual curiosity that not everyone has or not everyone keeps, you know? So it’s a it’s lovely advice. What’s your third piece?

Speaker4: Third piece.

Speaker3: I think it’s kind of such an interesting question. I was telling Prav, it’s [01:29:00] perhaps a question that some of it could be, you know, I’ve done this, so you do it too. But another way of answering that question is I didn’t do this, but you should. You know, like when you know yourself really well, that’s that’s another way of answering the question. You know, I tell my kid, hey, I didn’t go to the gym, but you do, you know, for the sake of the argument.

Speaker4: It’s interesting you say that because I’ve.

Speaker1: Always tried to live life, to not have those regrets. Yeah, and it’s hard. It’s [01:29:30] easy to say, but hard to.

Speaker4: Act on for sure.

Speaker1: And that’s why I look back to my six months. And I remember thinking to myself, I’ve got I may have one, three, 6 or 12 months off. And I had a plan for each one, like skeleton plan on paper as to what I would do, where I would go. And and it landed on six. And I just followed that plan.

Speaker4: And it was a quick summary.

Speaker3: Of what you did in that.

Speaker4: Six months, quick.

Speaker1: Oh, so I’ve always wanted to get into mountaineering and I did a little bit with the Navy, you know, small [01:30:00] stuff. So I thought, okay, I’ve got six months, let me see what I can do. So I started with Mont Blanc as a training climb, which was super fun to learn about, kind of all the equipment side of things. And then I did a big one for two months in Nepal, Mt. Manaslu, which is, if you’ve seen 14 peaks with Nims Dai, he was with us out there. He’s it’s one of the 14 peaks, basically. And that was incredible. Just such a great experience with the Sherpas. Lovely.

Speaker4: Had you climbed at all before this?

Speaker1: Nothing high, nothing high altitude. So I’d never used kind of supplementary oxygen [01:30:30] or done rotations until that point, which is why the Mont Blanc climb was a training climb, so physically quite demanding. So I had to do a good amount of training before then. I did some scuba diving with a friend in the Maldives afterwards as a bit of a holiday, and then the final trip was Antarctica in December. In January we’re doing some mountaineering out there, pulling sleds along, getting very cold.

Speaker4: Oh my goodness.

Speaker1: Which was which was awesome.

Speaker4: Oh my.

Speaker3: Goodness. Wonderful.

Speaker4: And you couldn’t.

Speaker1: Couldn’t have done and could have gone Antarctica without having done the high altitude stuff in Nepal. [01:31:00] Because you’re not allowed, you’re too dangerous because you need to have experience in cold environments, tent living because Antarctica has no fixed structures at all.

Speaker4: So is your third piece.

Speaker3: Of advice take a six month sabbatical?

Speaker1: Yeah, it’s kind of along those lines is to not live with any fear of losing something because we really have nothing to lose, although it seems like we do. You don’t want to get into a point where you think, oh, well, I should have done that. I should have tried [01:31:30] that.

Speaker4: Yeah. You know.

Speaker3: I’ve found now I’m getting to that age where you start regretting stuff. Yeah. Like, okay. Much as you try not to. Yeah. The not having gone for something regret. Yeah. Tends to come from a position of fear and just decisions. Decisions that come from a position of fear in general are pretty bad decisions.

Speaker4: And it comes from all.

Speaker1: From the simplest decision as asking someone you like out for a drink. Yeah, all the way up to buying a home or [01:32:00] trying to buy a home or starting a business. All these things, and they all come with risk of rejection, failure and financial ruin. All these things that I’ve kind of been through all the three scenarios and you feel better having even even if it doesn’t go your way.

Speaker4: Yeah. Having tried.

Speaker1: Yeah. You feel better if you tried and failed, if you haven’t tried and failed and you go back and think, oh, well, what if it could have worked, then what?

Speaker4: Yeah, very true. I’d say.

Speaker1: I’d say give it a punt. Take a try, take advice. Be careful. [01:32:30] Don’t be, don’t be, don’t be kind of reckless. Yeah, but give it a try.

Speaker3: Very good advice. It’s been lovely. Lovely chatting with you, man.

Speaker4: It’s been great.

Speaker3: I’ve really, really enjoyed that. Time flew by. Thank you so much for doing that, buddy.

Speaker4: Hey, it’s been great being so open.

Speaker3: Wonderful.

Speaker2: This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts. [01:33:00] Payman Langroudi and Prav Solanki.

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