Former BACD president Andrew Chandrapal discusses his journey in dentistry, from his early days balancing dental school with music aspirations to becoming a respected clinician and educator.
He shares insights on the value of humility in dentistry, the impact of social media on patient expectations, and the significance of building trust with patients.
He also reflects on his experiences with the BACD and his approach to teaching.
Enjoy!
In This Episode
00:02:55 – Early years
00:05:35 – Personal loss
00:07:35 – Dentistry Vs music career
00:09:40 – Ego and humility
00:16:50 – Social media
00:23:55 – Treatment planning and patient communication
00:31:30 – Full mouth rehabilitation
00:47:50 – Blackbox thinking
00:55:05 – Teaching and education
01:16:35 – BACD
01:22:20 – Quick-fire questions
01:27:25 – Fantasy dinner party
About Andrew Chandrapal
Andrew Chandrapal is an aesthetic and restorative dentist and former president of the British Association of Cosmetic Dentistry (BACD).
Payman Langroudi / Andrew Chandrapal: None of us like failure. Yeah. That’s universal. Yeah. Um, but failure is inevitable. [00:00:05] It’s just when it happens. And so the reality. Are you less likely to go and try [00:00:10] and fix, be a hero and fix something that you really, you know, something that hasn’t got much there [00:00:15] nowadays? Um, I wouldn’t say that, but I’m less likely to do it on someone who [00:00:20] I feel. Um, personality wise is going to, is going to then say, well, the treatment [00:00:25] that you did hasn’t worked out. Now, what are you going to do about it? Yeah. So it really is the personality type [00:00:30] and the dynamic or the ideology of that patient that will drive me the right patient. You would do that? [00:00:35] Absolutely. Um, and notwithstanding the fact that I’ve learned from other people [00:00:40] how to then try and do forms of heroic antics that actually I would have [00:00:45] never have tried before.
[VOICE]: This [00:00:50] is Dental Leaders, the [00:00:55] podcast where you get to go one on one with emerging leaders in dentistry. [00:01:00] Your hosts Payman Langroudi [00:01:05] and Prav Solanki.
Payman Langroudi / Andrew Chandrapal: It gives me great pleasure to [00:01:10] welcome Andrew Chandrapal onto the podcast. Andrew is a all [00:01:15] round good guy musician. Um, for me, the [00:01:20] when I think about you, Andrew, I think about like almost the bridge between single tooth and [00:01:25] full mouth dentistry. If I wanted to understand that [00:01:30] point of difference, you’d be the person I’d go to. And [00:01:35] also the kind of dentist for me, the kind of dentist you refer family and friends to. And I [00:01:40] can’t think of a sort of a bigger thing that you could say about someone, right? Because that, [00:01:45] you know, there are there are dentists who do lots of different things, but then there are some who you feel like have [00:01:50] got the holistic knowledge of what’s going on. Um, pleasure to have you. [00:01:55] Thank you for inviting me. Yeah. Finally. Yeah. I’m not going to say anything. [00:02:00] 250. Wow. That’s all good. We first met. If I [00:02:05] want to guess around 2005 or 6, I want [00:02:10] to say something like that. When did you call the fire? 2001. Yeah. You [00:02:15] were like, a 4 or 5 year qualified. It was even then. Very talented. Well, I’m [00:02:20] not sure. Yeah. Yeah. You were. The first question really is, were you always [00:02:25] driven work wise, or was there a moment that you became [00:02:30] driven? Were you driven like in university as well? Yeah, that’s an interesting question. [00:02:35] Um, no. No. And I think, I think if you referred [00:02:40] to the musician element and I suppose for the first three years, [00:02:45] my gigging and musical performance stuff was the forefront [00:02:50] of my head and heart at Birmingham.
Payman Langroudi / Andrew Chandrapal: Yeah. At Birmingham. And so unbeknown to my parents. [00:02:55] I’d be travelling down most weekends into London. Oh, really? And from Brum [00:03:00] and doing some gigs with some band mates, buddies and what have you. And then [00:03:05] travelling back on Sunday night. And I actually found, I found the cheapest tickets [00:03:10] on National Rail. It was a £12.50 ticket. I’d missed the end of my lectures on the Friday [00:03:15] afternoon bus down and come back on Sunday night for £12.50. I was like Bob on, unbeknown [00:03:20] to me, losing out on some of the social affairs at university [00:03:25] and not really feeling the vibe of dentistry at all. So it’s a very functional, kind [00:03:30] of purposeful thing up until year three. And at that point there was a tutor at [00:03:35] Birmingham, a lovely fella. His name is Don Spence, and he [00:03:40] sat me down and said, Andy, you know, you’ve got [00:03:45] some potential. And there I was, you know, like long haired kind of and, and [00:03:50] he said, but you need to change your Anyways, and because [00:03:55] you’re not going to get through it otherwise. And so I kind of set up for a night or two trying [00:04:00] to think about where I was, where I was going, where I potentially could go. And [00:04:05] um, two days later, I cut my hair, stopped gigging, told roommates [00:04:10] that’s it, and got into it, and, and I and [00:04:15] I realised at that point I have a fairly obsessional methodology in life.
Payman Langroudi / Andrew Chandrapal: So I kind [00:04:20] of delve in fairly deeply, and that was the first poignant moment. I ended up [00:04:25] doing okay at uni as a result of that in those last two years. The other poignant moment, I guess, was [00:04:30] what I presented at BCD one time, which was my [00:04:35] father passed in 2005, and I kind of adopted a bit of a head down approach [00:04:40] in dealing with that. And grief does funny things to you. Yeah. And I think at that [00:04:45] point in time, I kind of just went head down into my work and never really came up. And [00:04:50] so that’s really adopted my work to life ratio, to a point [00:04:55] where I felt adapting that obsessional mentality early on, [00:05:00] and then that almost traumatic point in life took me to [00:05:05] a point where I have to go headfirst into everything that I do. And was it to do with your [00:05:10] relationship with your dad and so much? I mean, was your dad saying be the best [00:05:15] or whatever? No. Was he that kind of. He wasn’t at all. It was how I dealt with my grief [00:05:20] of losing him when I wasn’t expecting to. Yeah. And I think [00:05:25] that’s how I dealt with it by busying myself. And [00:05:30] because my music had taken a bit of a sideline, I was then thrust into, I’m the eldest, [00:05:35] one of my family, of my generation.
Payman Langroudi / Andrew Chandrapal: And so it was a responsibility issue [00:05:40] as it was. Then all of a sudden you go from kid to I was in my mid to late 20s at that point, [00:05:45] and all of a sudden, you know, you’re thrust into in an Asian family to be [00:05:50] the head of your family. So it was very much a caring thing that I had done for my for my mum. And my [00:05:55] brother was here. He was only young, but then actually a few years later he emigrated to Sydney. So [00:06:00] from that point, it’s then been a very kind of insular [00:06:05] relationship with my mum and I. And that configuration, that dynamic changed. [00:06:10] And so all of a sudden I had my work. I was fortunate enough to have what will end up to be [00:06:15] my family at that point. And um, yeah, it’s it’s been go, go, go since. [00:06:20] And the music, how deep were you into that? Like when you say coming down to London [00:06:25] gigging, were you in a band like, did you ever consider music as [00:06:30] a career? Yeah, 100%. So 100%. So. So was dentistry sort of just [00:06:35] an insurance policy? How what was going through your head? So I wanted to I was given opportunities [00:06:40] to, to become part of studios or to do, um, international session [00:06:45] performing. Oh, really? Um, prior to uni. And it was a conversation that I had with [00:06:50] my folks and they never really beat me into submission. [00:06:55] I wouldn’t say that, but they certainly made their opinions known.
Payman Langroudi / Andrew Chandrapal: Um, you [00:07:00] know, having come to the UK in the early 70s and, um, and, [00:07:05] and fought tooth and nail, you know, what it’s like to get here and to, to, to make [00:07:10] a living and to raise a family. And then you’ve got your, your eldest son saying, no, I want to do music, [00:07:15] you know. Um, I don’t think it’s sat well with them. It’s not like it would be now. And [00:07:20] so I think. But then you say that, right? But, you know, your kids are [00:07:25] getting to that point of A-levels and things soon. Yeah. If one of them [00:07:30] says I want to write movies. Yeah. Are you cool or were you or what? [00:07:35] What’s your advice? Yeah. You know, actually, my advice or actually both [00:07:40] of our advice to the kids is not really about if you if you [00:07:45] want to be a hairdresser, be a hairdresser. But don’t just be a hairdresser. Own your business. Own a salon. [00:07:50] Think about teaching others. Think about influencing others. Think about aspiring others, [00:07:55] then own another salon and then become a group. So it it [00:08:00] just be the best you can in what you do. Yeah. Or attain to be the best you can. [00:08:05] Uh, whether they want to be writers, poets, musicians, whatever, that’s cool. But [00:08:10] I think the mentality is the important thing. And without getting too deep into it, I think that’s what’s [00:08:15] led me to to a stable point in my career.
Payman Langroudi / Andrew Chandrapal: Um, dentistry. We’re lucky we [00:08:20] have the ability to do several things. Yeah. But I think the mindset is the same whatever [00:08:25] industry you might be in and the sort of the age old question about dentistry for your [00:08:30] kids, would you encourage them to become dentists or are you the opposite? [00:08:35] Because I get both sides. Yeah. You know, when people ask, well, [00:08:40] let me flip it. When people answer that question, they base based their own rhetoric and the [00:08:45] rhetoric of others that they know to answer that question. And I’m like, you know what? We [00:08:50] will make the best of whatever we do. And the [00:08:55] generation before you and I treated dentistry in a different way to we do the way [00:09:00] we do and have done and the generation ahead of us the same. And so you make the best [00:09:05] of your generational kind of culture and dynamic. And so if they chose to do want to do dentistry [00:09:10] or any other vocation like medicine, I wouldn’t discourage them, but I’d encourage them to make the best [00:09:15] of it. Um, I don’t like the idea of basing our decisions based [00:09:20] upon legacy, because actually, the older you get, you realise how times must and [00:09:25] do change. So I if they choose to want to go [00:09:30] into dentistry, let them do it. But don’t give them expectations based upon what you’ve achieved, [00:09:35] or don’t have expectations upon what you’ve achieved, because your kids are different to you. [00:09:40] True. But look.
Payman Langroudi: What I’ve done.
Payman Langroudi / Andrew Chandrapal: A lot.
Payman Langroudi: Maybe. Maybe I’ve done this wrong. I’ve. [00:09:45] When people have said they want to do medicine, I have tried to discourage them. And [00:09:50] anyway, you can’t discourage someone who wants to be a doctor. That’s one of those things that happens [00:09:55] when you’re, I don’t know, 11 years old. You decide you want to become a doctor and you can’t stop that guy [00:10:00] becoming a doctor. But my brother’s a doctor. And, um, I’d much [00:10:05] rather my kid became a dentist than a doctor for. For his own well-being. [00:10:10] Tell me why. For his own well-being, you know. For his own well-being. Okay. In this country. In this country. [00:10:15] Yeah. Might be a different story somewhere else.
Payman Langroudi / Andrew Chandrapal: So let’s look at that. Let’s look at that. I mean, like, you’ve got [00:10:20] young doctors, right? Who have always been beaten into submission. That’s what being a young medic is like. [00:10:25] You are the bottom of, of your sort of professional tree. And that’s what grows [00:10:30] you to be humble within your team. And hopefully most people remain that way. And I [00:10:35] just wonder, and this may be kind of a little cutting what I’m going to [00:10:40] say, but I just think people’s expectations about what they demand from their career [00:10:45] is changing. Yeah. People’s expectation about how much or how little they want to work [00:10:50] is changing. Yeah. So that eternal balance upon what we do is changing. And [00:10:55] so with that, when you then find yourself in a situation where actually the realisation is that these [00:11:00] poor junior doctors have had the experience that they’ve had, I feel for them, [00:11:05] I really do. I genuinely do because the NHS now is different from 20 or 30 years [00:11:10] ago. Yeah. Um, but there, there [00:11:15] is a way forward. So expect less from your life at that stage [00:11:20] to get to a better part. I know it’s not that simple, [00:11:25] but I think that, you know, there’s a way [00:11:30] through this. There’s a way through it for sure.
Payman Langroudi: For sure. Look, we still need doctors, right? Right. There’s no doubt about [00:11:35] that. My brother’s a senior consultant, though, And, um, so it’s not only the junior [00:11:40] experience that I’m talking about. And hey, by the way, that’s just my brother’s experience, right? I’ve [00:11:45] got lots of friends who are happy doctors, too. Yeah, but with your own kids, what [00:11:50] ends up happening is a lot of the. What? I find a lot of the nice talk about let them do what [00:11:55] they like comes out from a lot of us. Yeah. Then most [00:12:00] kids don’t have a passion like you had. Yeah.
Payman Langroudi / Andrew Chandrapal: You know, it’s funny. That’s. I [00:12:05] forced myself to love dentistry. Low pay, you know.
Payman Langroudi: But a passion for music is what I’m [00:12:10] saying. Yeah. Most kids, you say, hey, what do you want to do? And they’re like, I don’t know. Yeah. Most [00:12:15] kids. So then. So then they in a way, they’re looking to you for, for for advice. And and the advice [00:12:20] you end up giving, I end up giving, strangely, is very similar to my parents [00:12:25] advice. And I never thought that would be the case.
Payman Langroudi / Andrew Chandrapal: You turn into your parents.
Payman Langroudi: Yeah, yeah, yeah yeah, yeah. [00:12:30] So tell me about dental school. Straight. You decided [00:12:35] you wanted to be good. What was your first job?
Payman Langroudi / Andrew Chandrapal: So, [00:12:40] interestingly, I, um, I qualified. [00:12:45] I got, you know, pretty well, um, in my grades at [00:12:50] qualification from Birmingham. And I don’t know what happened. I must have done a really [00:12:55] poor CV or put my face on it or something ridiculous like that. I [00:13:00] didn’t get, um, any any immediate offers where it might. The [00:13:05] rest of my housemates were getting offers and and I was thinking to myself, what’s going [00:13:10] on? You know, have I put something wrong in my CV? Did my personal statement not read well? Um. Is my report [00:13:15] bad? Should I not put my face on the TV? Um. And I got this one offer. [00:13:20] I met this guy in West Brom, West Bromwich, which is about 20 [00:13:25] 20 minutes from central Birmingham. His name was Dai Gyngell and [00:13:30] he, uh, he’s a Welsh, um based GDP [00:13:35] trainer for a number of years. And he said to me, I don’t understand why [00:13:40] you haven’t had a job offer before. And I said, well, that’s really kind, but could I have a job, please? And [00:13:45] he goes, yeah, sure. And he probably influenced [00:13:50] me the most at that time and since.
Payman Langroudi / Andrew Chandrapal: And [00:13:55] he was the most humble, adorned [00:14:00] dentist I to this day have ever met by his team and his [00:14:05] patients. But he just sat in his hole and did what he did for years. [00:14:10] And he and his wife, his wife was the PM. Um, she’s no longer with us. Um, sadly. [00:14:15] And, um, he lived in the same house that he practised in. So he was never late for work. [00:14:20] Obviously, he just had to go from the landing from one side to the other side of the landing. But at the same time, [00:14:25] if there was someone that needed some help, um, they’d be knocking on the door all hours of night and [00:14:30] day, and he would see them. Yeah. And it wasn’t about the quality or the scale of his dentistry. [00:14:35] He wasn’t aiming to be something that he wasn’t. He’s just his mindset. His attitude [00:14:40] was, we are just dentists and we are here to help. We’ll be benevolent when we [00:14:45] can and we’ll do what we can. And it was just amazing.
Payman Langroudi: I [00:14:50] know exactly what you mean. That set up, that’s that was a very common setup. Living in the house with [00:14:55] your wife as the as the practice manager. A pillar of the community? Yeah, 100%. And and [00:15:00] within that being a pillar of the community, if someone was in pain after [00:15:05] hours, those dentists would see them.
Payman Langroudi / Andrew Chandrapal: You’d open up.
Payman Langroudi: You know, and and I [00:15:10] mean, it’s a funny thing, I think a lot about what does it mean to be a professional. [00:15:15] Right. There’s so many different aspects to that. Right? Yeah. Um, [00:15:20] I think one one important part of it is, and [00:15:25] dentistry really lends itself to this, right, is what is it you do when no one’s watching? [00:15:30] You know, um. And no one’s watching. Yeah. Even [00:15:35] your nurse can’t see what the hell you’re doing. Yeah, yeah. No one’s watching. Yeah. Um, [00:15:40] but then these things that you’re talking about here, being there for people, putting [00:15:45] other people in front of yourself, right. That’s in the end. That’s. That’s the important thing. Um, [00:15:50] we’re losing that a bit in in that way of [00:15:55] working, that pillar of community way of working, we’re losing a little bit. [00:16:00]
Payman Langroudi / Andrew Chandrapal: I’m glad you say that.
Payman Langroudi: Well, yeah, we are, we are. But but but you know, you said society is evolving [00:16:05] here and society is evolving. You know, that there was a time when the local policeman used [00:16:10] to slap the kid, and the father would thank him for it, [00:16:15] you know. You know, there was. Society is changing. Yeah. Um, but you know [00:16:20] where it changes. And don’t worry, one of my, one of my quickfire questions is going to be what [00:16:25] grinds your gears?
Payman Langroudi / Andrew Chandrapal: Yeah, yeah yeah yeah yeah yeah.
Payman Langroudi: F. All right, so, look, I think [00:16:30] the first boss is just a massive influence, a massive, massive influence. It just sets the trajectory [00:16:35] for where you’re going on this issue of ego. Why [00:16:40] do you think we see some super talented [00:16:45] dentists who don’t have it? Didier. Dc would come to mind [00:16:50] one of your degrees, right?
Payman Langroudi / Andrew Chandrapal: Agreed.
Payman Langroudi: And then some [00:16:55] dentists who just ruled by it. And I always find [00:17:00] that it’s almost like there’s acceptable cover in in. [00:17:05] I’m thinking about the patient’s best interest. So I’m going to destroy what you just said [00:17:10] on social media because I’m thinking about the patient’s best interests. You know, you [00:17:15] can you can cover yourself with that cover, and then you can be as vindictive as [00:17:20] you like. What are your thoughts?
Payman Langroudi / Andrew Chandrapal: I think dentistry, as [00:17:25] I’ve observed it over the years gives us all the opportunity [00:17:30] for self, Lord, adulation [00:17:35] and opinion.
Payman Langroudi: Opinion write strong opinion.
Payman Langroudi / Andrew Chandrapal: Well when you’re [00:17:40] when you’re when you’re when you’re congratulated many, many times by both your patients, [00:17:45] your your team, you. There is a temptation [00:17:50] within your practice to become bigger than actually what and who you are. Yeah. [00:17:55] Add social media into that. Adds maybe a presentation or two into that. [00:18:00] You become bigger in the region or nationally or internationally. And I think that [00:18:05] sometimes it’s very, very easy to lose sight of your place, your position [00:18:10] in this world. And, and I see that happening because dentistry is so [00:18:15] visual, it’s so creative. And the net effect on the patients [00:18:20] to which we serve has the potential to be life changing In [00:18:25] such a small part of the body. Where else does that happen? And I think where [00:18:30] where you get that adulation, particularly on social media, you become you become [00:18:35] maniacal sometimes. Or I see people that do so and [00:18:40] then they go around the full circle and that maniacal nature becomes more humble, um, [00:18:45] because they realise their position or actually they become humble, but they’re really in the background. They are egotistical. [00:18:50] Uh, but then you have, as you say, other members of the [00:18:55] community and within our profession who are just benevolent, [00:19:00] continually trusting and giving, [00:19:05] constantly will admit their fears, will admit their failures, and [00:19:10] just be there to up the game to raise [00:19:15] the bar.
Payman Langroudi / Andrew Chandrapal: Yeah. And I have tried to seek those out. [00:19:20] And in the journey you find the egotistical ones and you learn what you need to [00:19:25] for them from them, and then you disregard the rest. And [00:19:30] when you’re or if you’re fortunate enough to become a responsible person within your profession, [00:19:35] which I think if you become high profile, whatever that means, you have a responsibility, [00:19:40] then you must self-reflect an awful [00:19:45] lot. That’s one of your responsibilities to self-reflect and realise actually what it is you [00:19:50] are achieving and what effect you have upon the people around you and your community. To realise [00:19:55] that actually I am just but a dentist, I just might be [00:20:00] more intense than other people. I’m just might spend longer doing things in terms of getting better or [00:20:05] what have you, or looking at my results and self-critiquing myself. But [00:20:10] you are just a dentist.
Payman Langroudi: Is it a muscle? Humility.
Payman Langroudi / Andrew Chandrapal: I [00:20:15] think it’s becoming one that we need to flex a little more.
Payman Langroudi: But you can train [00:20:20] yourself to become because you you for me. You really are that guy, right? Like someone who knows [00:20:25] so much and yet so humble with it.
Payman Langroudi / Andrew Chandrapal: I, [00:20:30] I don’t like anybody who.
Payman Langroudi: It’s [00:20:35] weird being revered for being humble. It’s a weird. It’s a weird paradigm.
Payman Langroudi / Andrew Chandrapal: Well, [00:20:40] I’m not sure. I’m not sure that I would see myself [00:20:45] as humble. I mean, it’s it’s it’s cool that you say that.
Payman Langroudi: That’s your humility saying [00:20:50] that.
Payman Langroudi / Andrew Chandrapal: But, but but at the same way, I can see those who brag. Yeah. And [00:20:55] every time I see some form of brag going on and I see it on social [00:21:00] media such a lot, I, I detach. Further and further away. If [00:21:05] I look at some of the memories that come up on, on Facebook, I call it the University of Facebook. [00:21:10] We can go into that one later. Yeah. But if I look at that, the memories that [00:21:15] I used to comment on things a lot more back then. I mean, you remember. Yeah. And now [00:21:20] I detach a lot more. You know, it’s not because I resent social media. It’s just [00:21:25] that I take it for what it is and and detach from the parts I don’t want to be part of.
Payman Langroudi: I [00:21:30] think all of us have been like that. Right? We. Social media is evolving. [00:21:35] I mean, there was a time, wasn’t there, that there were massive, huge arguments [00:21:40] on social media that you didn’t see them so much anymore?
Payman Langroudi / Andrew Chandrapal: Not so.
Payman Langroudi: Maybe I’m not on Facebook anymore. Maybe that’s [00:21:45] the reason I’m not seeing them.
Payman Langroudi / Andrew Chandrapal: It’s awesome. You’re right. I don’t think there’s as much [00:21:50] going on. Yeah. But I think instead, I mean, if you look on sort of TikTok and my my nurse, [00:21:55] she’s all of 19. She’s she’s great. But she asked me to then set up a TikTok [00:22:00] account, or rather more. She did it for me. Yeah. And I went through [00:22:05] on the feeds and it will obviously attract towards the Dental kind of profession. And I see [00:22:10] you know what’s on there. I see the level of promotion going on or information. Some of them are great because I want [00:22:15] to provide information to their to their audiences, or hygiene and [00:22:20] health and promotion, that type of thing. But others are doing crazy ass dances in their [00:22:25] surgeries. Do you not agree with that? Just for shits and giggles, maybe I don’t. Do you not agree with that? Oh, [00:22:30] should you not be professional? Well, should you [00:22:35] not be professional or should you? I mean, I get it. I love the bit of having fun and keeping the [00:22:40] vibrancy for your profession. Get it? But at the same time, [00:22:45] professional standards are what builds the the profession [00:22:50] to be what it is. Uh, to a degree. And I think standards [00:22:55] need to be maintained. And I wonder whether the time spent on academia [00:23:00] or improving your skill or your art could be equally as committed [00:23:05] to as the time some people spend on social media because, as I understand it, it’s a big commitment when [00:23:10] you do social media properly, right? Yes. I mean, some people spend hours on it per week, right?
Payman Langroudi: For [00:23:15] some people it’s it’s their source of patience, right. You know.
Payman Langroudi / Andrew Chandrapal: That’s an interesting dynamic [00:23:20] too. That’s a real change from back in the day.
Payman Langroudi: Yeah. But look, I remember someone, [00:23:25] you know, an older lady dentist telling me once that, [00:23:30] you know, dentists shouldn’t be in bikinis on social media. Mhm. [00:23:35] And now it’s like par for the course.
Payman Langroudi / Andrew Chandrapal: Have [00:23:40] you seen me in one.
Payman Langroudi: I’m looking for.
Payman Langroudi / Andrew Chandrapal: I’m sorry.
Payman Langroudi: I’m looking forward to see. [00:23:45] So you know the evolution of that. I mean yeah the it’s a funny thing. It’s [00:23:50] a funny thing I don’t know man. I, I’m, I’m pretty addicted to TikTok myself. Yeah. [00:23:55] Yeah. I’m not seeing anyone dancing. Right. The algorithm figures out what you want, [00:24:00] right?
Payman Langroudi / Andrew Chandrapal: I don’t know.
Payman Langroudi: No, it does sometimes. So, like, I’ve been [00:24:05] watching some some dude getting his ears waxed for hours. It [00:24:10] was. It was some dude cleaning the horse horseshoe or something. Yeah yeah yeah yeah, [00:24:15] yeah, stuff like that seems to get you. Yeah. Um, but I don’t think it’s clear yet where [00:24:20] dentistry and TikTok, for instance, is. And Instagram, it’s become very clear [00:24:25] before and after is beautiful things. Yeah. Tiktoks. No [00:24:30] one’s really worked it out. No one’s really succeeded on it.
Payman Langroudi / Andrew Chandrapal: Were in this really new era, though, because of our [00:24:35] regulators and say what we will about them, but they’re just not used to this type [00:24:40] of, um, dynamic. And, and we’ve always had [00:24:45] blurred lines of what it is to be professional. We take an implied Hippocratic oath [00:24:50] in terms of what we do. We have more social responsibilities as healthcare professionals, [00:24:55] whether we like it or not, just like the police do, just like medics do. So that limits [00:25:00] us because of our profession. And I’m not sure you can resent that. It just is. [00:25:05] So when it just is, you kind of have to draw the line at a point. [00:25:10] But I don’t want to sound old and cranky about that. I want to be dynamic to it. [00:25:15] And so I understand the need that patients are attracted to what [00:25:20] they see and what they hear on social media, and that’s a mode of how dentists get [00:25:25] their patients. Sometimes I worry for younger dentists getting patients on that medium because are [00:25:30] they limiting themselves to a personality? Typing that, for example, isn’t in [00:25:35] anybody’s best interests, but it seems to work. What does that [00:25:40] mean? Well, the whole aspect of attracting [00:25:45] patients via social media can work really successfully for many [00:25:50] individuals, and I applaud that. And I think that in this dynamic era, it [00:25:55] needs to be done for many, and it should be done for many. Um, but on [00:26:00] the very, very few patients that that I have had, [00:26:05] and when I talk to friends and colleagues about this, the type [00:26:10] of patient that you sometimes get through on social media or via social media, sometimes [00:26:15] don’t have the, um, the values. I’m being really [00:26:20] generalistic here, but, uh, the, the values that maybe your [00:26:25] general patient might. So let me give you an example. Yeah. [00:26:30] Instant gratification. They want an instant result and they want it to last for the summer. Right. [00:26:35] So if you then provide that service for it to last [00:26:40] the summer and your your mantra for that is because the patient wanted it, does [00:26:45] it mean we should provide it? I don’t know.
Payman Langroudi: Well, we come down to sort of informed [00:26:50] consent and all that. Right. Um, right. But I hear you, I [00:26:55] definitely hear the fact that patient comes in saying, I want composite bonding. Yeah, maybe [00:27:00] composite bonding is not the right treatment, right? Yeah. Um, but social media [00:27:05] has a way of sort of getting people into a particular [00:27:10] treatment, and that in itself is unhealthy. You know, people come in saying, I want [00:27:15] something just because they saw it on social media. Right. Um, but but then I guess that’s, [00:27:20] you know, that’s part of our job, right? Communication has always been part of our job to to make them understand. But the question [00:27:25] of, you know, would the daughter test sort of that you’re alluding to? I [00:27:30] guess it’s your daughter’s choice. It’s not your choice. It’s your daughter’s choice. [00:27:35] What she wants to do. Yeah. Yeah. And although, you know, informed consent isn’t [00:27:40] so black and white as as I’m portraying it, but informed consent [00:27:45] is informed.
Payman Langroudi / Andrew Chandrapal: Yeah.
Payman Langroudi: Yeah. So if this adult [00:27:50] is informed, it’s not our job to say yes or no. [00:27:55] It is our job to say, I’m not going to do this for whatever reason. [00:28:00] Yeah. I’m not comfortable with this. Yeah. But that sort of agency of the [00:28:05] patient is important. Yeah. So as [00:28:10] an example, would I drill a 19 year old’s teeth for veneers [00:28:15] today? Probably not. Yeah, but if the 19 year [00:28:20] old was some model who thought that that was the right thing for her career and understood [00:28:25] because I informed her of the risks, then [00:28:30] it’s not my decision. It’s her decision. Right. Otherwise, I didn’t inform her [00:28:35] properly. Right. And that’s the key. That’s the key, right?
Payman Langroudi / Andrew Chandrapal: That is the key.
Payman Langroudi: And you’re right. There’s [00:28:40] financial incentive not to fully inform. Yeah. And that now we’re getting into what [00:28:45] is it to be a professional?
Payman Langroudi / Andrew Chandrapal: Yeah. And it goes full circle, doesn’t it? Because we’re also dealing with cultural values. [00:28:50] If I look to my friends in the Middle East, if I look to my friends in South America, there’s [00:28:55] a much more there’s a far greater sort of trend towards indirect dentistry. Yeah. Irrespective [00:29:00] of the age to some degree. And if I, if, if we look at Europe [00:29:05] and if we look at here, perhaps we are sort of evolving to a minimally [00:29:10] invasive sort of, um, level of dentistry that is probably [00:29:15] greater than it should or needs to be, because minimally invasive doesn’t mean no prep. We know this, [00:29:20] right? Minimally invasive means that you do what you need to do and no more to get the desired [00:29:25] result. So if you need to prep, you prep. But at the same time, um, [00:29:30] I think that sometimes the additive, um, element of what we [00:29:35] are doing in conservative dentistry is probably used and abused, which is influenced [00:29:40] by some of the trends that are followed. So this becomes then a service that’s provided because [00:29:45] it is a trend and because you get healthily remunerated, dare I say it becomes a trend [00:29:50] even more. And we go back then to the ego. Yeah. So then to then post [00:29:55] or illustrate cases where we don’t really consider the, [00:30:00] the, the, the, the results of what will happen and what it will look like in years to come. [00:30:05] Are we doing that patient a disservice? Is that patient fully informed from the word go? [00:30:10]
Payman Langroudi: By the way, is the dentist fully informed?
Payman Langroudi / Andrew Chandrapal: Is the dentist fully informed?
Payman Langroudi: That’s maybe the.
Payman Langroudi / Andrew Chandrapal: Key, right. As [00:30:15] a as a result of that, where is this consent element. Yeah. You know, where is the professionalism. [00:30:20] And that worries me because I see beautiful work being done by a number of our colleagues [00:30:25] worldwide. And I’m talking about additive dentistry. I also see an absolute shit [00:30:30] tip of work that’s taking place as well. And I a little bit of me just gets firstly upset, [00:30:35] um, and concerned for that individual because I work with some of the defence companies [00:30:40] as well. And I see what happens. And then part of me gets a bit [00:30:45] bit cross bit what bit cross cross.
Payman Langroudi: Yeah.
Payman Langroudi / Andrew Chandrapal: And [00:30:50] I think we can do better guys. Yeah. We can do better. Let’s do better because [00:30:55] we, we are part of the influence as well.
Payman Langroudi: Well sure man. Look, if incorrect work [00:31:00] is being done or incorrect consent is is all of that’s true? All [00:31:05] of that is true. There’s no there’s no doubt about that. And we all see crappy dentistry breath left, [00:31:10] right and centre.
Payman Langroudi / Andrew Chandrapal: We see me. We see mediocrity. That’s functionally correct. [00:31:15] And that’s what I learned at an early point. And that’s what has built a [00:31:20] lot of functional dentistry in the UK and abroad for many, many years. And for the majority [00:31:25] of the population, it serves them perfectly fine.
Payman Langroudi: But then looping back to the social [00:31:30] media thing, um, you’re absolutely right in that it’s easy. [00:31:35] Social media is kind of like a like an echo chamber, right? Yeah. So [00:31:40] it’s easy to flick through your Instagram and think [00:31:45] that the majority of dentistry that’s happening is what’s happening on [00:31:50] your screen, right, because of that echo chamber. In the same way as if I’m a BNP [00:31:55] guy, I keep getting fed the same stuff now, I think. Oh, there’s [00:32:00] loads of us right here thinking that. And, you [00:32:05] know, this notion of the amount of dentistry that’s happening [00:32:10] in the country. 95% of it. Isn’t this right? Maybe 5% [00:32:15] of it is that. But who’s warning who on that subject? [00:32:20] Yeah, I think me and you are in trouble understanding this [00:32:25] much more than the younger generation. I mean, they’re native, and they know. [00:32:30] They know the guy sitting on this private jet does not own a private jet. Yeah. [00:32:35] Me and you are like, wow.
Payman Langroudi / Andrew Chandrapal: Maybe, [00:32:40] maybe. And you’re right about, you know, because social media brings [00:32:45] you in it. It makes your world smaller. Yeah. And it surrounds, um, you. [00:32:50] It’s surrounded by you. So it makes you feel special because social media [00:32:55] designed. You know it to surround you and you become the centre of that [00:33:00] universe. That’s why all of a sudden you become bigger than you think you are. Yeah, a lot of the time. [00:33:05] Um, but at the same time, uh, [00:33:10] like you rightly say, um, it’s really important to be able to then see through what we see. [00:33:15] So I can now at the point where I can say what type of lighting, what type of photography, what type [00:33:20] of bounces are being used. Yeah. To then hide the things that we clearly see [00:33:25] that actually are there, you know, both in direct and indirect. And because it’s so visual, a lot [00:33:30] of the time it’s aesthetic based work, you know, and, and and that’s before [00:33:35] any form of modulation or modification has come into play. So when you can start [00:33:40] to see through that, you start to just think it’s a real bit of a shame, because what you’re not emulating [00:33:45] is the is the reality of the situation for the patient rather than the [00:33:50] the trying to concentrate on the applaud of the end result that [00:33:55] you want to perceive you’ve achieved. Yeah, there’s a big difference between the two.
Payman Langroudi: Yeah, but what is it? What [00:34:00] is social media? Yeah. In the end, yeah. It’s I mean, [00:34:05] I’d say a marketing tool when it’s being used in dentistry. [00:34:10] Now you post. Right. Yeah.
Payman Langroudi / Andrew Chandrapal: Every [00:34:15] now and again.
Payman Langroudi: Not a lot. Yeah. You don’t post a lot. Um, neither do I when.
Payman Langroudi / Andrew Chandrapal: I know how to. [00:34:20] Neither do I. Look at the instruction manual. Neither do I.
Payman Langroudi: But. But your market, if [00:34:25] you like inverted commas. Here is dentists. Right. So it’s super important. Like someone like [00:34:30] you must not use the right, the wrong balances and and the wrong lighting [00:34:35] and all of that. Someone like you needs to do things exactly correctly, as [00:34:40] per what a dentist needs to see in that photo. But the majority [00:34:45] of people are on there trying to attract patients, right? And listen, I totally get it. [00:34:50] There’s no point seeing a before and after without seeing the prep, right? But patients don’t want to see [00:34:55] the prep. Know they have to bear that in mind.
Payman Langroudi / Andrew Chandrapal: 100%. And and you know, [00:35:00] there’s a term that’s been coined, I suppose, over the last ten years, like this whole emotional dentistry thing. [00:35:05] Yeah. And, you know, where you have sort of beautiful videography and production. Yeah. Haunting music [00:35:10] and all the rest of it come into play. And I think the production and the work taken to do some of the stuff that some [00:35:15] people are doing is phenomenal. It really is. I mean, I’m like, I’m sitting there with my iPhone going, [00:35:20] oh my God, it’s the wrong way up, you know? So I feel completely primitive in that world. And [00:35:25] I absolutely applaud the efforts that some are going to to produce that. You just [00:35:30] want to make sure that the quality of what’s coming out, when it comes down to ground level. Yeah. Is [00:35:35] just, um, is safe, predictable and has a longevity to it that we would expect [00:35:40] for our kids or for our partners.
Payman Langroudi: Let’s get on to some clinical stuff. [00:35:45] Um, I asked this question. I know it’s bloody unfair question. [00:35:50] Yeah, yeah. But I love it. And you [00:35:55] do a lot of full mouth stuff. Yeah. And you know, you teach [00:36:00] a lot of single tooth stuff as well, right? You do both. You cross both. Give [00:36:05] me. Is this a ha moment I’m interested in an aha [00:36:10] moment for you around occlusion. The biggest subject in [00:36:15] the world. Yeah. Okay. Yeah, yeah. But what comes to mind? I don’t know, doesn’t need to be the crux [00:36:20] of it, but what for you. I mean, you did the whole voice continuum. [00:36:25] Where was it in that in that continuum that something grabbed [00:36:30] you and thought, oh, I get that more now.
Payman Langroudi / Andrew Chandrapal: Yeah. So I think [00:36:35] when I started, um, Voices Continuum, it was about [00:36:40] 2007, 2008, something like that. And I had questions over [00:36:45] the huge amounts of confusion that was given [00:36:50] to me by the courses and the continuums I had attended as a as a young graduate. To that point, [00:36:55] I was only out of out of school for for 6 or 7 years. Um, but I had done enough [00:37:00] to realise I wasn’t getting the binary answers that are needed with the results that I was getting. And, [00:37:05] um, the the beauty, of course, [00:37:10] continuum was the fact that everything was manifested in a checklist type methodology. [00:37:15] And I love that. I think as dentists, we love that, right? We like recipes. And, [00:37:20] uh, Ronaldo Hirata does a similar type of thing. Yeah. And [00:37:25] when I got this kind of checklist, this cookbook of recipes, [00:37:30] it was all based around valid science, where John had then gone [00:37:35] through scientific papers from the last 50 years, sieved out the tripe [00:37:40] and kept the the good stuff, and built this continuum around that. Not [00:37:45] to improve your hands, but to improve your thinking, to make yourself more methodical, [00:37:50] and to then categorise things where possible to give [00:37:55] you the answers about the outcome and thus the predictability of what it is you’re doing.
Payman Langroudi / Andrew Chandrapal: And [00:38:00] that has really structured. That was a game changer for me. Um, and [00:38:05] that really structured my restorative pathway from single tooth dentistry to, to multiple [00:38:10] tooth dentistry. And I think that has really changed things and remains to, to this [00:38:15] day. And it’s amazing that when you learn implant dentistry, [00:38:20] for example, your oral orthodontics, you are taught from the word go from the get go to have [00:38:25] the treatment plan to have to walk skeletal base there. In what incisal [00:38:30] relationship are they in and all the rest of it? What’s the bone type like? Type one, type four, blah blah blah. But [00:38:35] when it comes down to the replacement of an incisor or composite, when it comes down to the replacement [00:38:40] of a class two um amalgam restoration on [00:38:45] a lower six. You’re never taught to treatment plan. Why it failed, what you’d do [00:38:50] differently and how long you’d expect that to then last. And then if you then multiply [00:38:55] that by a number by quadrant, or then by an arch or by two arches, what [00:39:00] the net effect of that is the effect of reducing ovd upon, um, [00:39:05] anterior guidance, the effect of a constricted envelope of function, which still to this day [00:39:10] isn’t really it’s misunderstood. It’s misunderstood, and it’s not represented enough in this [00:39:15] country.
Payman Langroudi: Yeah, not in undergrad at all. Right? No. And it’s a simple concept. In the end. It’s simple. [00:39:20] In the end, it’s a simple concept.
Payman Langroudi / Andrew Chandrapal: Concept?
Payman Langroudi: Yeah, it did a bit for that.
Payman Langroudi / Andrew Chandrapal: Tiff [00:39:25] has really helped that I think in his in his own way. He’s sort of, um, [00:39:30] you know, uh, aided the, the concept to be [00:39:35] more exposed as it needed to be in this country. And, and, but John [00:39:40] has been talking about this since the early 80s, as has have as have [00:39:45] many others. Um. It’s just that I felt that John’s approach, [00:39:50] again, his humility has is something that’s really attracted me about him [00:39:55] to, um, to his the way he delivers the message and the way that I absorb it. [00:40:00] Yeah.
Payman Langroudi: Tell me about Chris. Yeah. Not not John, but [00:40:05] Chris. Yeah.
Payman Langroudi / Andrew Chandrapal: So the course continuum is is, um, Seattle is [00:40:10] based in Seattle, where John has been located for decades. He started [00:40:15] a really, really small, intimate study club with his buddies, um, sort of back in the 70s. [00:40:20] Um, and it or it could even be the early 80s. Um, and [00:40:25] this grew, um, to kind of a more regional thing. And then he [00:40:30] took a leap of faith and began a centre in the early 90s that nearly ruined him because [00:40:35] he put a lot of money and time and resource into it. Um, and he’s grown it into this [00:40:40] sort of, um. Comfortably kind of large sort [00:40:45] of study, um, arena where he has his own office there. He conducts [00:40:50] the majority of the teaching still to this day, over nine modules, has people [00:40:55] from around the world come along. And he split it up into restorative modules of occlusion treatment [00:41:00] planning, um, periodontal interface biomechanics and implants and things, and [00:41:05] basically updates it every single year with all of the literature, literature that comes [00:41:10] through. And he himself pushes himself, um, as is now entered into the digital arena [00:41:15] and has probably one one of the most prolific, um, individuals, research [00:41:20] fellows who is who is with him producing some amazing research in [00:41:25] the quality of digital. Um, and he’s just a continual innovator. [00:41:30] So he’s a really inspiring character. Um, and [00:41:35] still to this day is going strong. Um, what is a module?
Payman Langroudi: How many days does [00:41:40] a module?
Payman Langroudi / Andrew Chandrapal: Typically it’s about three days. But what he did is that for international [00:41:45] people who obviously have to fly in, he’s then sort of done a track course where you do two [00:41:50] of the modules longer hours for five days. So you’re there by half, six in the morning [00:41:55] and you’re not leaving till about seven, half seven in the evening, which is kind of what I’ve tried to base my [00:42:00] courses on. Sometimes it works, sometimes it doesn’t. Yeah.
Payman Langroudi: Depeche likes that [00:42:05] to get people running off to the toilet twice, three times during lecture. [00:42:10] Well, the culture.
Payman Langroudi / Andrew Chandrapal: Of learning, and also an interesting thing because as [00:42:15] I went over to the States and started doing that, I mean, my first exposure was with Pascal [00:42:20] Meunier in 2005. I went over to Foster City to Ideo, [00:42:25] and I met him and Michel at that point, and I hadn’t you know, that was the last time I effectively [00:42:30] prepped for a crown in over a decade, you know, and and that style [00:42:35] of learning, that intensity of learning stuck with me. Yeah. And culturally, [00:42:40] we’re not used to it here even now.
Payman Langroudi: What is it about manure [00:42:45] or cows or spear that you know, so many people say [00:42:50] it changed the way I practice. Is it the content or is it the delivery, [00:42:55] or is it both?
Payman Langroudi / Andrew Chandrapal: I think you see the content. You see the passion [00:43:00] more than anything. You see the consistency. I mean, I have my own views about [00:43:05] many of the educators that have inspired me. Pascal has to a point. [00:43:10] Pascal is different now to how Pascal used to be, but John is [00:43:15] consistent and I love consistency. I think that that stands [00:43:20] for a lot. I think you can base your legacy on being consistent. Um, and be [00:43:25] that good or bad, I might add. And um, when, um, [00:43:30] you look at these people over the years, they have been researchers, [00:43:35] they have been clinicians, they have been educators, and all of that’s [00:43:40] difficult. I mean, now that I’ve lived some level of that in [00:43:45] my own boots now for the last 15 years, I understand how tough that is.
Payman Langroudi: Yeah.
Payman Langroudi / Andrew Chandrapal: Um, and [00:43:50] so I applaud these individuals.
Payman Langroudi: So, you know, there’s an element of [00:43:55] simplifying the complicated, but my personal bugbear [00:44:00] is the opposite, right? Someone’s trying to complicate the simple. Right. And [00:44:05] almost it’s like to fill a lecture up or something to pad it out or something. Yeah. [00:44:10] Yeah. That that’s my personal bugbear. I mean, it’s one of the reasons I really like Chris Hall. Yeah. [00:44:15] He just tends to simplify things. Yeah. And, but but then, you know, it’s simplifying [00:44:20] isn’t simplicity. Like, it shouldn’t be simplistic. Right. [00:44:25] Simplistic. There’s a there’s a, there’s almost like a breadth and depth discussion. [00:44:30] Right. That you need to cover the breadth and then at the right point do the depth bit. [00:44:35] Um, but you’re right, I mean, Pascal, I [00:44:40] got the same feeling from him. Just the passion, you know, but.
Payman Langroudi / Andrew Chandrapal: Also that’s [00:44:45] where education then has its commerciality, and that’s where education starts to be, starts [00:44:50] to get a little bit soured, I feel anyway, you know, because actually to catch [00:44:55] an edge, if you are an aspiring educator, um, um, or [00:45:00] an established educator aiming to keep relevance in the market, [00:45:05] sometimes I see that people start overcomplicating what [00:45:10] never needed to be complicated. And as a result of that, they become inspirational [00:45:15] in that overcomplicated thing, and it starts [00:45:20] to trend and all of a sudden, oh, I’ve got to know a bit about that. And then all of a sudden they raise a court, they [00:45:25] start a course, all of a sudden they have a load of feedback, and then all of a sudden that feedback turns [00:45:30] viral. All of a sudden it becomes a thing. How is it a thing? It never needed to be a thing. What [00:45:35] was working before worked perfectly fine. Don’t make it a thing.
Payman Langroudi: We’re [00:45:40] going to get to the. What grinds the gears. Yeah. Do [00:45:45] you want to give an example of that or.
Payman Langroudi / Andrew Chandrapal: No. Um.
Payman Langroudi: No.
Payman Langroudi / Andrew Chandrapal: We [00:45:50] could do. I mean, look, I think I think the people that are at the forefront [00:45:55] of our research and our education, um, have a responsibility [00:46:00] to find simplification where it’s appropriate and to [00:46:05] define complicated or complex procedures where they are appropriate. But [00:46:10] to simplify something, um, you have to then be bringing [00:46:15] a solution to the people’s problems, to find [00:46:20] a solution to the people’s problems, the problems have to be generalised and big enough in the [00:46:25] first place. So when you’re doing a class two restoration or an Mod [00:46:30] restoration. If you are not looking at how you isolate, how you selectively [00:46:35] etch when you’re using a self adhesive, how you then incrementally layer how you look at morphology [00:46:40] as a point of occlusal contacts and stressing of the um, of the buccal, lingual and [00:46:45] axial walls. If you’re not looking at all of that, but instead putting a bit of fibre in the base of the cavity, [00:46:50] I have a problem with that. Yeah, I get it. I [00:46:55] get it. So I think more overly let’s stick to the basics [00:47:00] and concentrate on those, because generation after generation, I’m fortunate enough to now be [00:47:05] teaching two generations of clinicians. The problems are the same.
Payman Langroudi: Yeah. You know, [00:47:10] the older I get, the more I realise expertise is just doing the basics [00:47:15] very well.
Payman Langroudi / Andrew Chandrapal: Right? It’s no more complex than that. And that will work for 80%, [00:47:20] if not 90% of your results.
Payman Langroudi: Yeah. Agreed? Agreed. On [00:47:25] this pod, we like to talk about mistakes. Yeah. Um, [00:47:30] I. You can look at it how you like. I’d like to buck [00:47:35] the trend of sort of, you know, the, you know, that black box thinking idea, um, [00:47:40] where we can learn from each other’s mistakes. Right. What comes to mind when [00:47:45] I say clinical errors? What clinical errors have you made that you think someone else [00:47:50] can learn from?
Payman Langroudi / Andrew Chandrapal: I make clinical errors all the [00:47:55] time, and and I think I want to be [00:48:00] my own worst critic on that, and I am I [00:48:05] don’t want I am my own. Um, my biggest critique, uh, if I look [00:48:10] at some of the common errors that I make, I [00:48:15] would say. If I look at [00:48:20] something like digital scanning, um, I, I’ve gone full [00:48:25] circle with digital scanning and realise what it can do very well and realise what it [00:48:30] currently cannot do very well. So for minimal prep stuff, let’s say like [00:48:35] a rooftop on lay prep that doesn’t um, um, cross [00:48:40] the contacts, I realised that taking a good, sharp impression is [00:48:45] often more accurate and more useful to the lab than a digital impression. Um, [00:48:50] and that may be sending people wild when I say that. And equally minimal prep veneers, [00:48:55] um, where you don’t cross the contacts, particularly in lower interiors, that [00:49:00] for me is served better with a really crisp, accurate impression, uh, [00:49:05] than a digital scan. Um, and again, I see results that are wonderful [00:49:10] using both techniques in my hands. I’ve learned that by making mistakes and [00:49:15] having things that don’t fit quite as well. Yeah. Um, you know, a lower right one that could probably fit [00:49:20] on lower left one if it really wanted to, you know, and that type of thing.
Payman Langroudi / Andrew Chandrapal: So that’s one of the big things. [00:49:25] And as far as direct restorations is concerned, where I will happily have all my hand [00:49:30] up and say I make errors all the time. I think it is errors of, [00:49:35] um, how I layer material down, how I see porosities, [00:49:40] how I deal with voids. Um, and actually, it’s not how I deal with voids, [00:49:45] it’s how I get past not creating them in the first place. [00:49:50] And a lot of that is just I sometimes don’t [00:49:55] pay attention to how I’m putting the material down, how the material needs to be treated, the pressure [00:50:00] that I put down. Um, and, and as a result, I create [00:50:05] problems for myself when I’m doing my finishing and polishing. So I make that [00:50:10] error a lot. Um, and then I suppose the last one [00:50:15] is then forgetting about when I’m doing sort of something that’s occlusal based, [00:50:20] forgetting the fact that, you know, you set someone up in centric relation if that’s what’s required, [00:50:25] and then you let them go on that and but then you forget that there’s emotional elements [00:50:30] that cause the occlusal issues as well.
Payman Langroudi / Andrew Chandrapal: And those are the non-quantifiable [00:50:35] values when you’re doing full mouth dentistry, the psychological, the [00:50:40] psycho psychosomatic elements of that to which sometimes you have to then [00:50:45] build in insurance policies. What do I mean by that? I mean technicalities like not making [00:50:50] indirect restorations massively morphologically. Correct. I [00:50:55] see beautiful morphologically primary, secondary, tertiary anatomy on posterior teeth a lot of the time [00:51:00] by these amazing technicians. But for locking people into a set pattern, a [00:51:05] lot of the time life isn’t like that. So again, I’ve learned that from John, making sort [00:51:10] of inclinations that are more forgiving to allow patients to glide a little bit [00:51:15] more, to not lock them in posterior anteriorly so that, you know, things like guards, for example, [00:51:20] aren’t staple, um, uh, diets that patients [00:51:25] have to commit to for the rest of their days after being rehabilitated. Would you? I’m not sure I would. [00:51:30] So I think that you have to you have to reconsider [00:51:35] all of the elements of what makes a patient, um, come to you [00:51:40] for occlusal or tooth wear problems. Um, is more than just the mechanics of [00:51:45] what we’re trying to look at. Um, so I have been guilty of making that mistake on many occasions. [00:51:50]
Payman Langroudi: And 18 years in the same practice, [00:51:55] nearly 20, 20 years in the same practice. You must have seen a lot of your [00:52:00] own work fail, right?
Payman Langroudi / Andrew Chandrapal: Absolutely.
Payman Langroudi: Is that the kind of thing that you’ve [00:52:05] these these examples that you’re giving? Is that is that where it’s come from, seeing your own work?
Payman Langroudi / Andrew Chandrapal: 100%. [00:52:10] I mean, I think, um, I’m massively fortunate. Uh, [00:52:15] very lucky to have been in the same practice for nearly 20 years. [00:52:20] It’s the.
Payman Langroudi: Best education.
Payman Langroudi / Andrew Chandrapal: Yeah, 100% the best education. Hands down. Because [00:52:25] you totally see the results. Um, not only clinically, but also emotionally in [00:52:30] your patients. And and if anything ever humbles you in terms [00:52:35] of the work that we are enabled to carry out by the people [00:52:40] that we stand on the shoulders of it, is that 100%? Yeah. [00:52:45] And and also in the same time, seeing how things don’t work, reflecting [00:52:50] on that, giving yourself a little whip on the on the back, not a pat a whip and saying, I need [00:52:55] to do this better. And then actually the ability to be transparent to your patient and say, you [00:53:00] know, Mrs. Smith, this didn’t go so well. I’m going to do this again for you. When [00:53:05] can you do it? Yeah. When can you make the appointment? Because I’ll fix it.
Payman Langroudi: I [00:53:10] think look, we’re in the we’re in the trust business more than any other business. Yeah. Mhm. We [00:53:15] are. And When a patient trusts you. If something goes wrong, [00:53:20] you can be upfront and fully transparent because you know you’ve [00:53:25] got that trust. And it’s a it’s a funny business in that sense, right? Because [00:53:30] the patient knows nothing about what’s really going on. There’s dentists [00:53:35] who treat patients like that. I worked in a place [00:53:40] that the principal was the most charming, one of the most charming people I’ve ever [00:53:45] come across. Like charming guy, man. But his work was behind. It was, [00:53:50] you know, he was stuck in the 60s or whatever it was. His patients [00:53:55] had no idea. His patients adored him. Adored him. And then sometimes you [00:54:00] get the opposite, which is that that’s a really heartbreaking.
Payman Langroudi / Andrew Chandrapal: Someone who’s technically excellently.
Payman Langroudi: Brilliant, [00:54:05] almost on the on the spectrum.
Payman Langroudi / Andrew Chandrapal: But has the social skills of a dead [00:54:10] end. Yeah, yeah.
Payman Langroudi: Yeah, yeah. And, you know, and how much of dentistry is the technical brilliance and how much [00:54:15] is I mean, one of my family members had a massive operation [00:54:20] and we picked the surgeon based on his, like, what a nice guy he was. [00:54:25] Yeah. And and you know, we know all about I mean, we knew what was [00:54:30] what, you know, who was who and so on. But the nice guy was a six [00:54:35] hour operation. Right. You imagine you want to look at the technical part of it? [00:54:40] Yeah. Um, so it’s a really interesting point. [00:54:45] Right. How much of the speed of trust [00:54:50] with patients? Yeah. Like when you’ve been somewhere for 20 years. Hopefully you’ve [00:54:55] done the right thing for long enough that people trust you. Yeah.
Payman Langroudi / Andrew Chandrapal: I see two patients [00:55:00] a month. It’s fine.
Payman Langroudi: Yeah. But some some people, when I say speed of trust, some people just [00:55:05] have a way about them that people trust them immediately. Um, [00:55:10] I see your alarm signs going off again. And some people don’t, you know. [00:55:15]
Payman Langroudi / Andrew Chandrapal: Well, I think I think again, we go full circle because this is the worry I have, particularly for younger dentists [00:55:20] and social media attraction, because with a lot of these patients, they [00:55:25] will self refer themselves because of what they see or hear. And as a result, they are [00:55:30] requesting, demanding um, a particular service or technique. [00:55:35] So a lot of the time the recall, the, the longevity [00:55:40] of establishing or the genuine nature of establishing that professional rapport [00:55:45] with that patient. So trust is then established is then very, [00:55:50] very challenging. Yeah. And it creates a hot lead that can sometimes not be [00:55:55] as genuine as a patient. That’s been recommended by a friend or a family member [00:56:00] or established over years of let’s do this now. Mrs. Smith, I think this is the [00:56:05] time where we should then do these few crowns for you, for example. Sure. Um, and I worry for that. [00:56:10] But what I do see, however, is these individuals create an environment [00:56:15] within their practice that looks second to none. You know, they have, um, they [00:56:20] have marketing designs, they have design, they have team members that are, um, you [00:56:25] know, sort of all saying and doing the same thing. A reception team that is second to none. Um, a [00:56:30] TCO that that is phenomenal. And I think this is how we have [00:56:35] really started to revolt, because actually the team approach, the team [00:56:40] creates the legacy and that rapport.
Payman Langroudi / Andrew Chandrapal: So the dentist is doing the carpentry [00:56:45] is one part of that. Yeah. And I think that’s really changed because go back back [00:56:50] in the day, the dentist was a really focal element, um, of that [00:56:55] um, of that practice. But now the team are much, much bigger within that. And I think that’s the [00:57:00] right thing to do. That’s the right way to be. So I think the dynamic has changed. [00:57:05] Um, but I, I still think that we need we are in the game of trust, [00:57:10] in the business of trust. And I think when you have that, you are able to then [00:57:15] sort of be transparent with your patients, be transparent with the treatment that’s that’s [00:57:20] being proposed, the risks inherent within that, the talking about [00:57:25] money, which is a stickler for many of us. And then also talking about patient responsibilities, [00:57:30] what they have to do to keep to keep things going. Because a lot of the time we don’t like [00:57:35] talking about that either. Yeah, yeah. And then how we deal and how we talk about failure, how [00:57:40] we how we can then sort of build the patient’s expectations [00:57:45] so that if there is a bump in the road, the reaction to that isn’t reactive. [00:57:50] Yeah. It is instead pragmatic.
Payman Langroudi: How do you see a big difference [00:57:55] between your patients in Bourne End and your patients at Dashwood and Tanner? [00:58:00]
Payman Langroudi / Andrew Chandrapal: Um, because.
Payman Langroudi: That that dynamic must be there, right? I mean, you’re meeting those [00:58:05] central London specialist patients almost bought for the first time [00:58:10] before you treat them.
Payman Langroudi / Andrew Chandrapal: Yeah. Um. Yes and no. I mean, because in Bourne [00:58:15] End these days, I’m fortunate enough to just see referral patients anyway. Oh, really? So they are tending [00:58:20] to be hot leads that that that know that they require something that’s another clinician [00:58:25] has recommended I treat. Yeah. Yeah. So in in Darwin Tanner it’s a similar type of [00:58:30] affair. However having said and done all that the the general patient [00:58:35] at Darwin Tanner is of a slightly different ilk. Um, but on the basis of geographical [00:58:40] location, reputation and legacy and what have you. So, um, but having [00:58:45] said and done all that, be it celebrity, be it anyone else or person of notoriety, let’s call [00:58:50] it that. They’re all treated exactly the same. And I’ve, I’ve sort [00:58:55] of developed over the years just to not be starstruck by anyone or anything. [00:59:00] Um, and to just have a very level head about who you’re treating, because at the end of the day, their teeth are the same [00:59:05] as the next person. And and I actually think sometimes there’s [00:59:10] a little bit of a binary response to that. So certain patients will expect to be treated [00:59:15] a certain way that is dictated by themselves, whereas I’m trying to then get [00:59:20] them around to be dictated by the mechanism of their dentition or their aesthetic needs. [00:59:25] And so a dentist can easily fall prey to the sway, if that makes [00:59:30] sense. Yeah. Um, whereas I try and build them around. And actually many patients, [00:59:35] particularly the alphas, respond really well to that, because if you say, what do you do?
Payman Langroudi: How [00:59:40] do you give me an example? You get some some high, high powered businessman who [00:59:45] comes in telling you what he wants done. Yeah. How do you handle him?
Payman Langroudi / Andrew Chandrapal: So [00:59:50] the power of communication, the power of spending time with that individual, the power of body language [00:59:55] and non-verbal communication, and the power of actually speaking to someone at their [01:00:00] same level, looking into their eyes when you speak. And then the power of also showing [01:00:05] some of the illustrations of cases that you’ve treated before and how this didn’t work out, but how this did work [01:00:10] out. You know, I find I have a fairly good level of conversion [01:00:15] with patients who are offered, um, with that. Not [01:00:20] everybody, but most. And and I used to be really [01:00:25] affected by those who didn’t take up the treatment that I was recommended, because this is how I [01:00:30] was taught to be predictable to, to to to be mechanistic in my, in my methodology. But [01:00:35] actually now I’ve seen it in a way that, okay, if you didn’t value the [01:00:40] things that I was saying or the way I was saying it, that’s okay. I will certainly reflect on [01:00:45] how I could have done that better. But on the other side of the coin, maybe I just [01:00:50] wasn’t the approach that you needed at that time. Yeah. And that’s okay.
Payman Langroudi: You don’t need to be everything [01:00:55] to everyone. Absolutely not.
Payman Langroudi / Andrew Chandrapal: You can’t. Yeah. You can’t be. Yeah. And and particularly [01:01:00] when you’re, uh, doing performing a type or a standard [01:01:05] of dentistry? Um, that is inherently higher in risk, let’s put it that way. [01:01:10] You need to be a little more binary. You need to be able to then say, no, [01:01:15] this isn’t going to work if we do it this way. And I don’t want that for you. And I actually [01:01:20] don’t want that for me either. That’s okay to say.
Payman Langroudi: Have you had to replace [01:01:25] failed full mouth rehabilitations a [01:01:30] lot? Yeah. Is that the most challenging thing you do?
Payman Langroudi / Andrew Chandrapal: It is. It is because [01:01:35] and I’ve had to do it from very, very eminent people that I respect hugely. Not because [01:01:40] things have gone wrong. It’s just time has fatigued the situation. I [01:01:45] might add that um, but um, but yeah. And they are difficult. I mean, in some [01:01:50] respects patients know what they have gone through in the past, or they have forgotten what they went through to get [01:01:55] to that point. Yeah. But also the level of restorative, um, breakdown of some [01:02:00] of those teeth is.
Payman Langroudi: Yeah. Once you get under there, it’s very complex.
Payman Langroudi / Andrew Chandrapal: And so you have an additional [01:02:05] layer of having to put that patient into provisionals, which are lab based and all sorts. And that pushes up costs, [01:02:10] that pushes up time. Um, and that actually reduces predictability to, to a [01:02:15] point. So you have to be then ever more binary with some of those cases where there’s a post crown [01:02:20] on a dodgy upper left lateral, you just don’t know where the crossover is going to then flex [01:02:25] that tooth so it pings. So how can you predict that for five years time? Yeah. [01:02:30] So is it that you run for the point of actually saying, do you know what, we probably need to then think about [01:02:35] where your mindset on this. If you’re happy for this to last for a few years, let’s run with it. If [01:02:40] you’re not, let’s run with something like a dental implant.
Payman Langroudi: And the let’s [01:02:45] call it hero Don ticks side. It’s a funny it’s a funny sort [01:02:50] of, uh, thing. You have to sort of you got on one side, you’ve got bonding, [01:02:55] getting better, the technology getting better. On the other side, you’ve got someone who wants to pay his 50 [01:03:00] grand or whatever it is, and get something that lasts some years.
Payman Langroudi / Andrew Chandrapal: Yeah, none [01:03:05] of us like failure. Yeah. That’s universal. Yeah. Um. But failure is [01:03:10] inevitable. It’s just when it happens. And so the reality. Are you less.
Payman Langroudi: Likely to go and [01:03:15] try and fix, be a hero and fix something that you really, you know, something that hasn’t got much [01:03:20] there nowadays?
Payman Langroudi / Andrew Chandrapal: Um, I wouldn’t say that, but I’m less likely to do it on someone who [01:03:25] I feel. Um, personality wise is going to, is going to then say, well, the [01:03:30] treatment that you did hasn’t worked out. Now, what are you going to do about it? Yeah. So it really is the personality [01:03:35] type and the dynamic or the ideology of that patient that will drive me the right patient.
Payman Langroudi: You would [01:03:40] do.
Payman Langroudi / Andrew Chandrapal: That? Absolutely. Um, and notwithstanding the fact that I’ve learned from other [01:03:45] people how to then try and do forms of Herod’s antics that actually [01:03:50] I would have never have tried before, such as partial extraction. What does that mean? So [01:03:55] effectively.
Payman Langroudi: The teeth and take half of it up.
Payman Langroudi / Andrew Chandrapal: Um, well, no, actually partially. Extract the tooth. [01:04:00] Splint it into position. Oh, so you’ve got greater coronal tissue to work with than.
Payman Langroudi: You know. [01:04:05]
Payman Langroudi / Andrew Chandrapal: I mean, very, very circumstantially led. But that’s the thing. [01:04:10] I learned that from an Italian prosthodontist. I mean phenomenal. It’s so simple [01:04:15] as well. But it’s like instant crown lengthening without having a higher gingival point than [01:04:20] the adjacent teeth.
Payman Langroudi: Wow, what an idea.
Payman Langroudi / Andrew Chandrapal: And so, [01:04:25] um, as an example, but that’s high risk treatment. I wouldn’t do it on someone who has an expectation [01:04:30] that this is going to work for years on end. You’re doing this because you have no other [01:04:35] choice, and because the only other choice is extraction.
Payman Langroudi: Take me through a case in terms [01:04:40] of, let’s say it’s one of these where you’re having to redo a full mouth rehabilitation in [01:04:45] terms of how many times are you seeing that patient before you actually start treatment? [01:04:50] What kind of costs does it run to? And you might find that distasteful. But [01:04:55] how long does it take? How much does it cost? All of that sort of [01:05:00] stuff. How many visits? What are we talking?
Payman Langroudi / Andrew Chandrapal: So I meet a patient initially for [01:05:05] a relatively short period of time, to work out and ascertain the nature of their needs. We have tcos [01:05:10] that will then brief me, but I need to meet that patient. I need to psychologically profile them, and they do [01:05:15] me. And I’ll also listen intently to my assistant at that time because I value [01:05:20] their opinion. Yeah. Um, especially the more experienced ones. And [01:05:25] and after that, they will have an expectation the patients will by, by means of the, [01:05:30] the TCO, that they will have to come back for a diagnostics visit where [01:05:35] we will spend another hour together, where we’ll take as much, extrapolate as much clinical data from the [01:05:40] patient as possible. In the meantime, I’ll have had some communication upon what I would like them to do. So [01:05:45] I have some forms that I have the patient complete in between that if they’re keen, they’ll do [01:05:50] it. If they’re not, they won’t. And that tells me something. Yeah. So I’ll carry on the conversation [01:05:55] at the second visit, and I’ll do all the work that we need to do. They’ll have an expectation at the end of that that there’s going to be [01:06:00] a letter provided for them in no more than two weeks. I [01:06:05] make it a point to deliver it in two weeks. If for any reason I can’t. I will be personally on the phone [01:06:10] to them to explain why and to apologise for it. Upon that, I’ll then have another [01:06:15] meeting with that individual. Now that instantly filters out a lot of people, because from the point of [01:06:20] you’ve made them jump through.
Payman Langroudi: Quite a lot of hoops, I.
Payman Langroudi / Andrew Chandrapal: Have. I have, and the people that are committed, [01:06:25] serious about it will all go through that. The ones that won’t, don’t value it. And that’s [01:06:30] okay. Yeah. They just I’m saving people. I’m filtering people through that process. [01:06:35] And so to the point to where we’re then having another conversation, be it virtually [01:06:40] on zoom, be it in person or on the phone, we then have given that patient [01:06:45] probably a week to go through their treatment plan, take all the parts through it, then I meet with them in person. [01:06:50] They’ll sign off and consent to all the key points that I’ve summarised in that treatment [01:06:55] plan. So the treatment plan, you know as well as I do, if I give someone a treatment plan of 5 or [01:07:00] 6 pages, they’re going to jump straight to the treatment fees. Yeah. And they’re going to look at [01:07:05] that and say, I can’t do that or I can do that. Yeah. Or some [01:07:10] of them will go through every element. But what I do, I then have what I want to put [01:07:15] down in the treatment plan, fees, etc., etc. I’ll annotate photos. Takes me a long [01:07:20] time to do. I charge well for it, but I’ll have a key summary points. Summary of [01:07:25] key points on one side of A4 that say all the pertinent points that that patient needs to [01:07:30] know. They’ll have to tick an initial every single point. Well, that I’ll go through them with.
Payman Langroudi: Oh, with [01:07:35] you.
Payman Langroudi / Andrew Chandrapal: Okay. Yeah. Upon doing that, then we sign consent and then we move. So that’s [01:07:40] three appointments down the way for the most complex case, for the ones that have the highest [01:07:45] risk and probably the highest financial value.
Payman Langroudi: How much are we talking?
Payman Langroudi / Andrew Chandrapal: So for the most [01:07:50] complex patient I’m treating currently, I’ve got a value of about 85 grand.
Payman Langroudi: And [01:07:55] how long will it take to deliver?
Payman Langroudi / Andrew Chandrapal: Probably 12 [01:08:00] months minimum.
Payman Langroudi: And where do you start?
Payman Langroudi / Andrew Chandrapal: Um, [01:08:05] a lot of the time. Phase one is stabilisation. Yeah. So [01:08:10] we’re trying to then unearth teeth of guarded prognosis. So we’re taking [01:08:15] disassembling restorations, having a look at what’s underneath, doing a degree of re prep rebuilding, [01:08:20] stabilising the the soft tissues around them and what have you. So we’ll do that on every [01:08:25] native tooth in the in the background. We’re then trying to find out a [01:08:30] little bit of detective work on the implants that are present, trying to make sure that we can find out each and every implant [01:08:35] specification. There’s a lot of background work that needs doing. Not every patient has that. I mean, that’s a minefield [01:08:40] in itself. And so once we’ve done that, I’ll put the patient into, um, [01:08:45] um, chairside temps and then lab made temps will then make sure [01:08:50] they’re aesthetically and functional, functionally stably stable for a matter of [01:08:55] no less than about three months. In that time, periodontist or myself will do [01:09:00] any soft tissue work grafting, crown lengthening, whatever is needed. And then we’ll get to [01:09:05] do that.
Payman Langroudi: Work yourself as well. I do. Oh, really?
Payman Langroudi / Andrew Chandrapal: Yeah. Um, and then we’ll get to a point where, [01:09:10] um, everything is stable. Patients are completely made up with everything, as am I. [01:09:15] And then we we transfer, um, upper and lower interiors, posteriors. [01:09:20] Off we.
Payman Langroudi: Go. And is that sort of fit day? Your what what [01:09:25] drives you in that? Like where do you get your buzz in all of this process. Do you get your buzz from [01:09:30] the planning stage, the prepping stage, the fitting stage or the social [01:09:35] side, the talking to the patient and solving their problem? Where’s your real buzz?
Payman Langroudi / Andrew Chandrapal: Uh, solving [01:09:40] the problem. I like the mechanistic of solving the problem. I [01:09:45] mean, once you’re actually delivering the treatment, it’s carpentry. You can either do it or you can’t. [01:09:50] Yeah. If you can’t do it, then you can train to do it if you want. If you can do it, then do it. But it’s [01:09:55] the it’s the it’s the strategy. I’m quite the strategist. Yeah. So I love that bit. [01:10:00] And actually when the patient sees that as well and gets it I’m like, wow this is amazing. [01:10:05] That’s really cool. And the and the buzz actually is provisionals. I get [01:10:10] those lab made provisionals on and everything. Everything goes and then they bite together. [01:10:15] And you’ve got one single when they bite together. I’m like, wow. Even [01:10:20] now, love that Basil.
Payman Langroudi: Loves the Provisionals.
Payman Langroudi / Andrew Chandrapal: Yes he does. Yeah. [01:10:25] I want to.
Payman Langroudi: Talk about teaching. Yeah. And within [01:10:30] teaching, I’d like to discuss you. I should have I should have, uh, introduced you as the past [01:10:35] president of the BCD as well. Um, teaching. I [01:10:40] mean, we do teaching. Is it’s high risk. Low [01:10:45] reward is really where I see it in.
Payman Langroudi / Andrew Chandrapal: What’s [01:10:50] happened to you? No, no.
Payman Langroudi: It is, it is. It’s high risk. Low reward. It is. It’s high [01:10:55] work. A lot of work in it. Yeah, it’s a lot of work, especially hands on. Right. Yeah. And maybe you don’t [01:11:00] handle the hands on side. No, I don’t do everything. No. It’s in the, the the the setup, [01:11:05] the cleanup for me. Is that you? I thought maybe the company, um. [01:11:10] It’s a pain in the ass. It’s difficult. Difficult work. Um, but [01:11:15] on the flip side of it, for me, the there’s, like, a [01:11:20] light bulb moment from the delegate somehow makes everything worth it. It’s [01:11:25] almost like, you know, the patient, this this full mouth rehab patient that we’re talking [01:11:30] about. Maybe she at the end of it all, she gives you a massive hug. [01:11:35] And truly, from the bottom of her heart. Thanks you. Yeah. Is worth more than the [01:11:40] 85 grand that she gave you. And it’s like, what drives us? Yeah, for me, it’s when a delegate [01:11:45] gets a light bulb moment. It just feels good to watch it. I’m [01:11:50] not normally the teacher, to tell the truth, but watch, watch that and then see the delegate doing something. [01:11:55] Yeah. How about you? What?
Payman Langroudi / Andrew Chandrapal: You’re right. Teaching [01:12:00] is a huge responsibility. I take it really seriously. [01:12:05] I put a lot of pressure on myself, um, to to to perform, [01:12:10] um, and to watch what I’m saying and to deliver how it needs to be said and to reflect off [01:12:15] of others that I have learned from. Um, there’s a huge amount of preparation that goes into [01:12:20] it. Um, and I reflect back on every course and [01:12:25] think, how could I have done that better? Could I have had more delegates or less delegates to [01:12:30] strengthen the message? And I think I see [01:12:35] the change in most delegates as we go along that journey, which [01:12:40] is at least two days. And the change is both in terms of body language [01:12:45] involvement. So you see, you get the passion level start to come up, but also [01:12:50] in attainment. But it’s not only that. I find [01:12:55] that many delegates come back to me on the support side of things, and [01:13:00] they’ll send me a message showing me a case when they didn’t have to do that because they’re busy with life [01:13:05] and what have you. And just to give me an example of what they achieved and how it’s [01:13:10] changed things. And I just love that. I’m like, whoa, that that’s [01:13:15] just quite something. And I think when you can have that impact and it need [01:13:20] be only something that’s just little, then it just I think that that really drives you. [01:13:25]
Payman Langroudi / Andrew Chandrapal: Um, I finished my courses and I am goosed. [01:13:30] Yeah. And I have done stupid [01:13:35] things in the past that I shouldn’t do and probably admit inasmuch as [01:13:40] I’ve okay, I. I am Indigo Dent. I am [01:13:45] Batman. I am Indigo Dent. Inasmuch as I’m the administrator, I’m. I keep [01:13:50] all the stock. I order the stock. I set up all yourself. Yeah. Wow. And then I [01:13:55] set down. I have support, um, mainly with Kolser who are amazing, [01:14:00] um, with. And for me and, um, they, they, they really help me. [01:14:05] Um, but they are my courses. So, [01:14:10] for example, when I do a course in Glasgow, I’ll drive up [01:14:15] on the Thursday. Um, sometimes I’ll do a morning session in the clinic [01:14:20] and then I’ll drive up. I’ll get there either at midday or at the end of [01:14:25] the day, about five hours set up for the course. Deliver the course Friday, Saturday, [01:14:30] Sunday. Take the delegates out for a meal. Sunday night, pack [01:14:35] up, drive home, get back about 4 a.m., wake up at six to [01:14:40] go to work the next day. Why’d you drive? Uh, because I’ve got so much kit and. [01:14:45]
Payman Langroudi: I send it.
Payman Langroudi / Andrew Chandrapal: I don’t send it because I can’t trust something to not turn up or something to get [01:14:50] delivered and damaged. You know, I’ve got usually 25 sets of hand pieces. I’ve got [01:14:55] all sorts of things. Um. Et cetera. Et cetera. So. And I guess, am I a control [01:15:00] freak or am I a micromanager? Probably.
Payman Langroudi: Yeah, probably. That’s harder than it needs to be, [01:15:05] isn’t it? But I get you, [01:15:10] I get you. Look, once, once we forgot mandrels. Right. There was a [01:15:15] good reason as well, right? We’d taken our drills to BCD, and there they didn’t [01:15:20] want them. And then someone in the warehouse forgot that or didn’t realise we’d taken them to BCD. And then [01:15:25] we didn’t have mandrels. Yeah. Yeah. Ruined the course. Ruined the course. I mean, bless his heart. [01:15:30] Lewis McKenzie. Yeah. Pulled out the stops. We were in Birmingham in the new hospital. [01:15:35] Yeah. Um, bless him, he he had, you know, he’s the kind of guy [01:15:40] who had 40 mandrels. So. Yeah. So, you know, he [01:15:45] brought out every polishing system he had or whatever. But but what I’m saying is something as small as that, something as tiny [01:15:50] as that can ruin a course. And so you can’t have you can’t miss anything. [01:15:55]
Payman Langroudi / Andrew Chandrapal: And that’s the thing.
Payman Langroudi: And stuff does go missing and stuff doesn’t arrive. And but to [01:16:00] put it in the car and drive. Jesus.
Payman Langroudi / Andrew Chandrapal: Yeah. And I [01:16:05] store my, my, my stuff at Darwood and Tanner. And so I, when I’m, when I teach elsewhere. [01:16:10] Yeah. I have to go there to take the car there and unload it and then do it. And I have a storage facility near my, [01:16:15] near my house, you know, so it the legwork is is mega. Um, [01:16:20] but that’s again why I only teach small groups. Yeah. You know, because [01:16:25] I have to make it logistically work. But I have to have the content for the delegate [01:16:30] to be, uh, concentrated enough to apply to them.
Payman Langroudi: And is there [01:16:35] not a member of staff that’s, like, fully on it? No.
Payman Langroudi / Andrew Chandrapal: I mean, one of [01:16:40] my nurses.
Payman Langroudi: For Cpds or they they cancel courses or. It’s me. Oh, [01:16:45] man. That hurts.
Payman Langroudi / Andrew Chandrapal: I sleep like Maggie Thatcher. That’s [01:16:50] the key. You don’t sleep.
Payman Langroudi: Do you not? Do you not sleep enough? [01:16:55]
Payman Langroudi / Andrew Chandrapal: I actually, I wouldn’t say I don’t sleep enough, I just don’t. I [01:17:00] probably need sleep, but I don’t. I’m. I’ll work till 1 [01:17:05] or 2:00 and that’s that’s back from the bad days. That’s back from seeking stage. Do you remember?
Payman Langroudi: Oh, [01:17:10] yeah. Yeah, yeah, yeah.
Payman Langroudi / Andrew Chandrapal: Um, so it’s back from those days and then wake up at six and crack [01:17:15] on. So if I, if I get four hours sleep, I’m good with it.
Payman Langroudi: Wow. What about [01:17:20] on the institutional level of education? Bcd well, sort of leading them. I’m [01:17:25] not going to call it a behemoth. It’s not. It’s not that big. But but leading an educational [01:17:30] institution. What are your reflections on that? Because everyone I [01:17:35] have asked about that almost says in a year’s not enough time to make any big change. [01:17:40] I think.
Payman Langroudi / Andrew Chandrapal: That’s fair. I think, um, Bacd is um, [01:17:45] is very close to my heart and has been incredibly influential and given opportunity [01:17:50] for many clinicians in the UK and beyond. And it [01:17:55] deserves to do well. It deserves to be directed and driven in the right [01:18:00] way. It deserves to to grow and to continue that influential [01:18:05] pathway. But to do that, um, we have been talking at board level when I was part of [01:18:10] the board, um, that the leadership probably does need a longer, a longer [01:18:15] term of service. However, um, constitutionally, you [01:18:20] already serve a very long term of service to get to that point in the first [01:18:25] place. And I think that that, influences your decision, [01:18:30] um, as to how much you can give. It’s largely a thankless task. [01:18:35] Um, and a lot of what goes on in the background isn’t really, um, [01:18:40] you know, uh, talked about or it doesn’t need to be talked about, but it is [01:18:45] a lot. Um, and I think. What do you mean?
Payman Langroudi: There’s a lot of work. [01:18:50]
Payman Langroudi / Andrew Chandrapal: There’s an awful lot of work in the background.
Payman Langroudi: Unpaid.
Payman Langroudi / Andrew Chandrapal: Oh, yeah. Yeah, absolutely. Yeah. [01:18:55] You do it, you know, to. Well, you do it to what I hope to be to improve [01:19:00] the face of, um, aesthetic dentistry within the UK and to drive the [01:19:05] academy forwards. Um, that’s what I hope you do it for. Um, and so as a consequence [01:19:10] of that, you give it your all like you do anything and, um, two years worth [01:19:15] terms of service as a, as a, as a ah.
Payman Langroudi: You think too much.
Payman Langroudi / Andrew Chandrapal: Is is a big [01:19:20] ask. I’m not saying it’s too much. It’s probably what’s needed. But it is a lot to ask when you’ve [01:19:25] already said.
Payman Langroudi: Individual’s going to have to put his life on hold for for two years.
Payman Langroudi / Andrew Chandrapal: Yeah, well, you’ve already [01:19:30] sat on the executive committee for two years before that. You’ve probably been a chair [01:19:35] of one of the boards. Yeah, but what.
Payman Langroudi: Does it mean? What’s what’s the commitment on the executive committee? Is it [01:19:40] that you’re having to answer questions throughout the week, or how many times do you have to meet. And so [01:19:45] what is it as vice president?
Payman Langroudi / Andrew Chandrapal: Historically, I’d be unsure as to it still being the way. But [01:19:50] as vice president you are effectively the treasurer. Mhm. Um, you [01:19:55] take care of the financial affairs, you become an officer, um, registered under companies House. [01:20:00] Um, and you have to take care of all the financial dealings, um, of, [01:20:05] of uh, of the BCD as. And you’re also flying the flag. [01:20:10] You’re probably educating at a point. Yeah. Um, and you’re meeting [01:20:15] with all the other, um, chairs of all the other committees. As president [01:20:20] elect, you are flying the flag and doing an awful lot of the running around that’s required [01:20:25] for the courses to work, for conference and all the rest of it. And as president, [01:20:30] the framework for that should be that you simply fly the flag. [01:20:35] Um, it depends upon what era of the bacd you have been part of. As to whether or not [01:20:40] that’s all you do. It wasn’t in my time, and it wasn’t for many of the other presidents, but, um, [01:20:45] you fly the flag, you send the message forwards, you present at the conference and such [01:20:50] the like. So within that, um, there’s a lot there’s a lot. I probably [01:20:55] didn’t see my kids the most during that point.
Payman Langroudi: I also saw [01:21:00] you at the Dental update. Yeah. Thing. How long have you been working.
Payman Langroudi / Andrew Chandrapal: For Dental [01:21:05] update? I think I’ve been with them for five years. 4 or 5 years, something [01:21:10] like that.
Payman Langroudi: Good group of people there.
Payman Langroudi / Andrew Chandrapal: I mean, immense I mean, if I [01:21:15] ever look to the group of people that influenced me as an undergraduate, where you [01:21:20] see their names on as the authors of the textbooks have been revising for the end of year [01:21:25] or end of term exams, and then you’re sitting on a committee with these individuals. [01:21:30] You’re like, my goodness. Uh, I mean, the first time I met Edwina, [01:21:35] I was like, whoa, what a kid. Yeah. I mean, it was just phenomenal. [01:21:40] And it puts you in your place. Yeah. Rightly so. And and it kind [01:21:45] of goes back to our initial conversation. Um, these people have, have grafted and [01:21:50] and tirelessly, tirelessly worked for the profession. Most [01:21:55] of them are deans of various Dental schools. Yeah. They they also know how to party pretty hard. Yeah. [01:22:00] Um, harder than I can. Uh, but. Yeah. Amazing. [01:22:05] Um, quite an experience. And obviously to work with, um, [01:22:10] with who you’ve mentioned before. Someone who’s dear to my heart. Louis. Yeah. [01:22:15] Uh, it was amazing.
Payman Langroudi: We’ve come to the end of our time. [01:22:20] I want to do a little quick fire round. It’s a new thing we’re doing. Um, [01:22:25] and then we’ll finish off with the usual questions. Yeah. What’s [01:22:30] a course that affected you the [01:22:35] most for your career?
Payman Langroudi / Andrew Chandrapal: The course continuum.
Payman Langroudi: What’s a course you’re desperate to go [01:22:40] on?
Payman Langroudi / Andrew Chandrapal: I’d [01:22:45] probably like to do Esteban Urban’s course [01:22:50] on, um, bone augmentation for. [01:22:55]
Payman Langroudi: For.
Payman Langroudi / Andrew Chandrapal: Uh, for bone grafting, for surgical [01:23:00] dentistry. Implants.
Payman Langroudi: Do you place implants?
Payman Langroudi / Andrew Chandrapal: I have done for 15 years.
Payman Langroudi: Oh, really? [01:23:05]
Payman Langroudi / Andrew Chandrapal: Yeah.
Payman Langroudi: So, David and Tanner, would you place the implants?
Payman Langroudi / Andrew Chandrapal: No. Um, Andrew places [01:23:10] the majority. Fiona, who’s a periodontist. Um, places some. I do all [01:23:15] restoration of the implants and what have you. Soft tissue work and things, but he would place them.
Payman Langroudi: Favourite [01:23:20] bit of kit?
Payman Langroudi / Andrew Chandrapal: Probably [01:23:25] my sable brush.
Payman Langroudi: Oh, that’s a nice composite brush. That’s [01:23:30] a nice answer. That’s a brilliant answer. What [01:23:35] grinds your gears the most about dentistry?
Payman Langroudi / Andrew Chandrapal: Uh, I [01:23:40] think that the need to feel lauded and applauded constantly. [01:23:45] Um, and the, the, perhaps the artificial [01:23:50] growth that that gives you. I think that we need to remember where we are [01:23:55] in life, where we what we do appreciate the changes that we’re able to make. But [01:24:00] let your growth be in perspective.
Payman Langroudi: What’s your favourite practice [01:24:05] in the UK? No self-nominations allowed.
Payman Langroudi / Andrew Chandrapal: Uh, my [01:24:10] favourite practice. Well. [01:24:15] Let me give you a hypothetical answer. The practice where [01:24:20] there’s a group of like minded clinicians that have been in the same place for a number of years who [01:24:25] have.
Payman Langroudi: Yeah, I’m not going to accept that. Oh my God.
Payman Langroudi / Andrew Chandrapal: Are [01:24:30] you asking me about a practice?
Payman Langroudi: Yeah, it’s your favourite practice. [01:24:35]
Payman Langroudi / Andrew Chandrapal: Man. Because [01:24:40] I have to think of individuals.
Payman Langroudi: Then what is one of your many favourite [01:24:45] practices? Because it’s a big ask to say your favourite. The best. Yeah. [01:24:50] Name for whatever.
Payman Langroudi / Andrew Chandrapal: Okay. You have to give me a minute. Um, [01:24:55] you know, I, I’m only a very, very small cog in it, but [01:25:00] I love what Andrew and Sue have done.
Payman Langroudi: A self norm.
Payman Langroudi / Andrew Chandrapal: Okay. Wow. [01:25:05]
Payman Langroudi: Yeah. I mean, listen, I hero worship David. [01:25:10] I really do, but you work there. You’re not allowed to say that. Okay. [01:25:15]
Payman Langroudi / Andrew Chandrapal: Okay. Can I. Mhm. [01:25:20]
Payman Langroudi: I really didn’t think this one would stump you so badly.
Payman Langroudi / Andrew Chandrapal: Yeah [01:25:25] it’s a tough one. Okay. I [01:25:30] think if I look at someone like Robert. Yeah. Who’s [01:25:35] a good buddy of mine. But also having gone round his practice has organised it in such [01:25:40] a way where the ethos is the same consistently the place [01:25:45] and positioning and the longevity and legacy of that practice has remained. I [01:25:50] love his energy. I love his technical, um, skills, and I love what the practice [01:25:55] achieves. I think probably more Park is a fantastic example of [01:26:00] how I would love, love to have owned a practice like that over the years. [01:26:05]
Payman Langroudi: Where is it.
Payman Langroudi / Andrew Chandrapal: In Moor Park? Where’s that? It’s not too far from kind of harrow. [01:26:10] Okay.
Payman Langroudi: Okay. Yeah. Books that changed your life. [01:26:15]
Payman Langroudi / Andrew Chandrapal: Okay. Uh, outliers to [01:26:20] prove to me that.
Payman Langroudi: Gladwell.
Payman Langroudi / Andrew Chandrapal: Yeah. By Malcolm Gladwell. [01:26:25] To prove that practice and repetition is everything. And that sheer, unadulterated, [01:26:30] unadulterated talent is maybe a touch overrated. Uh, [01:26:35] black box thinking. Uh huh. Um, to then make sure that [01:26:40] you look at all of the points of your of your journey [01:26:45] to make sure that you take care and care for each part of that to create an [01:26:50] overall improved result, and probably clinically. [01:26:55] Yeah.
Payman Langroudi: Favourite. Favourite Dental book? Yeah. Yeah. That’s going to be the next question. Yeah.
Payman Langroudi / Andrew Chandrapal: Um. [01:27:00] Probably. Oof! [01:27:05] I’d [01:27:10] say Mike Weiss’s management [01:27:15] of the failing dentition.
Payman Langroudi: Yeah. I thought for you that would be the right move. Yeah. [01:27:20] Amazing. So the final question is a fantasy dinner party. Three [01:27:25] guests. Right? Dead or alive, who would you have? Okay.
Payman Langroudi / Andrew Chandrapal: I [01:27:30] would go. I [01:27:35] would go, Jemmy Page, LED Zeppelin’s nice guitarist. [01:27:40] I would probably [01:27:45] go with. Someone [01:27:50] like. Uh. [01:27:55] Someone [01:28:10] like Marie Curie. And [01:28:15] my dad.
[TRANSITION]: Oh.
Payman Langroudi: Nice. It’s been [01:28:20] a massive pleasure, man. Thank you. It’s been a pleasure. Thank you so much for coming.
[VOICE]: This [01:28:25] is Dental. Leaders the podcast where you get to go [01:28:30] one on one with emerging leaders in dentistry. Your [01:28:35] hosts, Payman Langroudi and Prav Solanki. [01:28:40]
Prav Solanki: Thanks for listening, guys. If you got this far, you must have listened to the whole thing. [01:28:45] And just a huge thank you both from me and pay for actually sticking through and listening to what [01:28:50] we had to say and what our guest has had to say, because I’m assuming you got some value out of it. [01:28:55]
Payman Langroudi: If you did get some value out of it, think about subscribing. And if you would [01:29:00] share this with a friend who you think might get some value out of it too. Thank you so, so, so much for [01:29:05] listening. Thanks.
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