Specialist endodontist Aram Navai says the number one skill for endo nurses is staying awake. 


In this week’s episode, Aram chats with Payman about the value of skilled nurses and the stigma around endodontics. 


Aram also recounts his journey to specialism in what is perhaps one of dentistry’s most intimidating disciplines and puts forward his nomination for the world’s greatest living endodontist.  




In This Episode

01.47 – The road to dentistry

10.04 – Study

16.46 – From A&E to specialisation

28.36 – Endodontics in practice

44.47 – Social media

47.19 – Being a visiting specialist

59.05 – Downtime

01.01.40 – Black box thinking

01.12.52 – Sub-specialisms

01.13.57 – International outlook

01.15.46 – Building referrals

01.21.36 – World’s number one

01.23.52 – Fantasy dinner party

01.26.35 – Last days and legacy


About Aram Navai

Aram Navai is a visiting endodontic specialist and the founder of the London Root Canal Clinic specialist referral centre.

Speaker1: The most important thing is a practice which is well run, has a principal who is present [00:00:05] and cares about the practice. I think no one will ever care about your business as much [00:00:10] as the business owner. And the practices which are really well run, have hands on owners. You know [00:00:15] that they’re on the ground, they’re making sure the staff are fine. They’re making sure all the materials you need are there. [00:00:20] They’re communicating with everyone you know. You can have the best practice manager in the world. And you know, that is also [00:00:25] very effective because again, practice managers do wonderful jobs that I think having a good practice manager [00:00:30] is, is, you know, it’s like gold dust. But yeah, it’s first of all how the practice [00:00:35] owner runs the business themselves. Then it’s the staff. You know, for me personally, [00:00:40] as someone who travels between so many surgeries, having a good nurse is absolutely [00:00:45] key. The nurses are the backbone of every practice, in my opinion, and the practices [00:00:50] which operate well have good nurses, nurses who are treated well.

Speaker2: This [00:00:55] is Dental [00:01:00] Leaders. The podcast where you get to go one [00:01:05] on one with emerging leaders in dentistry. Your [00:01:10] hosts Payman Langroudi and Prav Solanki. [00:01:15]

Speaker3: It gives me great pleasure to welcome Doctor Navi onto [00:01:20] the podcast. Mbe is a specialist endodontist who works at [00:01:25] just eight practices in London, all of them in central London, all of them very [00:01:30] high profile friends of mine, many of them friends of mine. And it’s nice to [00:01:35] go into the specialities a little bit and find out your story. Welcome [00:01:40] to the podcast, buddy.

Speaker1: Good evening Payman. It’s a privilege and honour to [00:01:45] be here. Thanks for having me.

Speaker3: A pleasure man. My pleasure. Sorry. I’m listening. This, this this podcast [00:01:50] tends to be more like, uh, beginning of your life to the end. So, like, [00:01:55] where were you born? Is the usual. Usual. First question. But. But lately, [00:02:00] I’ve been wanting to just ask the question I want to ask straight away. And then and then and then [00:02:05] we’ll go and then we’ll go backwards. Yeah. So. And really the question is around specialising. [00:02:10] Did you always know that you were going [00:02:15] to be a specialist.

Speaker1: So as you learn throughout this podcast, [00:02:20] my decisions early on weren’t always based on the most logical [00:02:25] and calculated reasons. So, um, [00:02:30] I think the initial attraction to Endo was in my third [00:02:35] year of dental school. My first endo case was a upper seven with [00:02:40] uh 90 degree curved palatal room. First one, first one. Yeah. So so obviously [00:02:45] I couldn’t do it myself. So cut a long story short in comes along, um, my [00:02:50] sort of endo tutor at the time, who was this very suave, [00:02:55] good looking Italian man who everyone, all the girls used to fancy. And he comes along, [00:03:00] brings his microscope in, and he sits there, bends the files, and [00:03:05] he looks really, really cool at what he’s doing. And I was just fascinated at this guy. I was like, wow. Like, you know, I was just [00:03:10] impressed by him as a person and then by what he managed to achieve by [00:03:15] treating that tooth and that canal like everything else in dental school at that point seemed mundane [00:03:20] compared to what this guy did. And I was just like, wow, I want to be him.

Speaker3: The [00:03:25] first endo amazing. Yeah. Which way did you study?

Speaker1: Uh, guy’s [00:03:30] King’s College London. Yeah. That’s. Yeah.

Speaker3: And so from that point, did you think I’m [00:03:35] going to focus a little bit on endo? But I’m really the question of specialising where I’m going with it because a [00:03:40] lot of people have that question of should they or shouldn’t they. And some people decide very early [00:03:45] on they are going to specialise. They just don’t know in what. And other people it almost happens by accident. Yeah. [00:03:50]

Speaker1: So that was the initial attraction with Endo. And actually when I left dental school, I still liked [00:03:55] it though I actually did as part of my case press, um, a retreatment, which, you know, most people [00:04:00] don’t get to do. Um, I then left dental school. Um, I will go into [00:04:05] that later if you want, but I did, uh, did my job, went into practice, [00:04:10] uh, put my hand in almost everything. So I’ve done all sorts of courses from implant dentistry, [00:04:15] short terme, ortho, you name it. And actually, I’m sad to say, for a while, [00:04:20] um, NHS system put me off endo and again, we can go into some detail [00:04:25] there as well later as to why that happened. But I thought about all [00:04:30] the different specialities and eventually came back around to Endo. The reason I chose endo was [00:04:35] a few different things. I mean, I always wanted to be very, very good at something. Um, [00:04:40] so specialism was kind of on the cards with Endo. I [00:04:45] love looking at things very closely, even when I was a GP. My head was always in the patient’s [00:04:50] mouth trying to see exactly what’s going on. I bought a three and a half times magnification [00:04:55] loupes, which, um, you know, wasn’t enough. And, you know, once I, [00:05:00] you know, got a peek through a microscope, I was like, wow. It was like a whole different world. The other thing is, obviously [00:05:05] it’s it’s this it’s, uh, it’s probably one of the most, if not the most complex [00:05:10] area of dentistry, and it’s the ability to be doing this thing, which is really [00:05:15] hard that, you know, not everyone can do. And you spend, you know, a lot of [00:05:20] time and effort doing it. And it gives you both the sort of instant gratification of seeing the case [00:05:25] once it’s done, you know, looking at those beautiful white lines that you’ve painted and of course, [00:05:30] the long terme gratification of then reviewing the patients, seeing the lesions healed, seeing the tooth is still there. [00:05:35] So those are generally the things that attracted to me to the speciality itself. Really. [00:05:40]

Speaker3: Tell me about when. When was it that you decided to be a dentist in the first place?

Speaker1: So, [00:05:45] um, as someone with an Iranian heritage, I was brainwashed [00:05:50] as a child to become a doctor, so you [00:05:55] know how it goes. So I remember when I was about five years old, I was blowing my, uh, birthday cake candles. [00:06:00] And my wish was, I want to be a doctor when I grow up. I didn’t even know what a doctor was, but I knew I wanted to be one. So, [00:06:05] um. So that was sort of upbringing.

Speaker3: Were you born here?

Speaker1: I [00:06:10] was born in London. Yeah, I was born in London. Mhm. And um. Yeah. So [00:06:15] I had that in my mind. Then I went to school. Um, I was, I was always pretty [00:06:20] good at school and pretty good at sciences, but my passion was actually music. [00:06:25] Mhm. I picked up a guitar when I was 12 years old, became obsessed with that, started, you [00:06:30] know, playing in bands. And I remember we had an aptitude test in school where, you [00:06:35] know, they did a bunch of tests and then they asked you what you want to be. And as my career choice, I [00:06:40] must have put a rock musician or something like that. So the school wrote a letter to my parents [00:06:45] saying, we’re very concerned about our future aspirations because we don’t think he has a [00:06:50] realistic, um, outlook. So anyway, cut a long story short. It came to this sort of time where [00:06:55] the Ucas application was due and I was like, okay, I’ve got to get serious about this. So [00:07:00] what I did is, um, I knew I was going to go into the medical field because I was, you know, conditioned [00:07:05] that way. And, um, so I thought, let me actually go and see what this is about. Let me see [00:07:10] what the word doctor means. So I went and did work experience at a GP surgery. [00:07:15] And the GP’s there seem didn’t seem very happy. Uh, and they told [00:07:20] me, please don’t become a doctor unless you really, really love medicine.

Speaker1: I was like, [00:07:25] okay, um, I went to a, uh, hospital pharmacy department and all I was [00:07:30] doing was stacking shelves, and I was like, that’s really not what I want to be doing. I went to Imperial [00:07:35] College, uh, research labs to see what the sort of researchers are doing there. And [00:07:40] again, there was just it just seemed really isolated. And, you know, I’ve always been a people’s person, and [00:07:45] I just didn’t like that sort of isolation. So finally I went to work, shadowed [00:07:50] one of my mum’s friends who was a dentist, and she was sitting there with a radio playing [00:07:55] in the background music, which is obviously, you know, one of my passion. And I just saw, [00:08:00] you know, smiling, talking to patients like, you know, she just seemed very sociable and happy in what she [00:08:05] was doing. And again, like I said, most of my reasons were based on a lot of logic. I just [00:08:10] I just looked at her and I was like, you know what? That’s what I want to be doing. So, um, so that’s that’s what got me into [00:08:15] wanting to choose dentistry. And obviously I was I was good with my hands, you know, I was a musician, [00:08:20] um, the whole sort of artsy, crafty parts of the thing attracted to me as well. So I picked [00:08:25] dentistry.

Speaker3: And did you consider leaving London or. Not at all?

Speaker1: Um, [00:08:30] I’ve always been. Okay, so I actually lived in Iran for six years. So. So [00:08:35] at, uh, the age of nine, me and my mum moved to Iran, and [00:08:40] I studied there for six years. We’d come back in the summers, but I [00:08:45] was there for six years studying, and there were probably some of the best years of my life, to be honest, it [00:08:50] was completely just the schooling system in Iran is so different to here. And, you know, I [00:08:55] made such an amazing group of friends, um, some some of whom I’m still friends with to till today. [00:09:00] And it was a really great experience, um, to experience that culture completely different.

Speaker3: How [00:09:05] did that how did that even come about? Like you were sitting in London. What happened?

Speaker1: So I [00:09:10] was told by my parents that they wanted me to experience the Iranian [00:09:15] schooling system and upbringing, and later discovered that their marriage wasn’t going that well. So, [00:09:20] so so, yeah. So, so they just wanted a break basically. And uh, yeah, that that [00:09:25] was the reason for that. But that’s what I was told at the time and I yeah, my dad still claims his part. [00:09:30] True. So, so so yeah. Um, so [00:09:35] you come.

Speaker3: Back at 16.

Speaker1: So I came back here at 15, 15, 16 for your first year of GCSE. [00:09:40] That was the 1998, I think. And yeah, started uh, [00:09:45] my GCSEs. I was really excited when I was coming back, I was telling all my friends because, you know, in Iran the [00:09:50] schools are all single sex. Um, so I was telling all my friends that I’m going to be going to school girls, this, [00:09:55] that or the other. And my dad comes and puts me straight into all boys Catholic school. So yeah. So [00:10:00] I didn’t get those perks there. But but yeah.

Speaker3: So [00:10:05] I went to Catholic school too. At one point it was. Yeah, the it was [00:10:10] the only school that would let us in mid midterms, you know, like we were running away [00:10:15] from Iran and like the one school that would let us in was just very, very strict Catholic school in um Gloucester [00:10:20] Road just off Gloucester Road. Um, yeah. I learnt a lot about the Bible.

Speaker4: Yeah, [00:10:25] I got an A.

Speaker1: In my religious studies, Catholic.

Speaker4: Catholic.

Speaker1: Christianity. [00:10:30] I went to confession a few times as well.

Speaker4: Yeah, yeah.

Speaker3: Yeah. My my memory the first [00:10:35] day of school was Ash Wednesday, first day of school. So I just [00:10:40] got there and they said, right, we’re going to church. And I was like, what the hell? And then you know what [00:10:45] Catholics did? They put a little cross on the on the, on the head. And I just couldn’t believe it was happening. I [00:10:50] was.

Speaker4: Scared. Yeah.

Speaker3: All right. So then university. Yeah. [00:10:55] Did you get in? You got in easily. Were you like a bookworm? You must have been right. [00:11:00]

Speaker1: Oh dear. Oh dear. So that’s that’s that’s one of, that’s the first, uh, sort of [00:11:05] failure of my life. So basically I went to my interviews. I got a. Unheard [00:11:10] of at the time offer from King’s College London, which was my first choice. I got an offer of ABB [00:11:15] back until my ACL, which was the first year of A-levels. [00:11:20] I was usually, as I said, always good grades. I got four A’s for my As. So [00:11:25] you know, I was pretty cocky, confident that I’m going to be fine. And then [00:11:30] I go in my A2 year and meet my first girlfriend and I fall in love. So obviously [00:11:35] being, um, silly 18 year old, I just started bunking school, hanging out with her. [00:11:40] All the rest of it left everything to the last minute, and I very sadly missed my grades to [00:11:45] go into the offer. So at that point, I had to make a decision of either redoing [00:11:50] my A-levels or going and doing another degree, and I couldn’t stand the prospect [00:11:55] of falling behind while my friends are going to uni. So I went and did biomedical science at King’s. Oh, [00:12:00] but then my luck came round because. So I went and did three years of biomedical sciences, [00:12:05] which I would like to say were valuable and equipped me with, [00:12:10] um, certain skills, but apart from the social side, really give me much.

Speaker1: So, [00:12:15] so no, I mean, it was it was good university experience, but I mean, I didn’t take a whole load away from the no [00:12:20] disrespect. I mean, if you want to go into sort of sciences and labs and stuff is good, but other than that didn’t give me [00:12:25] actually, I really enjoyed psychology. I have to say, I did psychology every year, which I found really interesting. But anyway, I was very, [00:12:30] very lucky because in 2005, when I finished my BSc, I got an offer for [00:12:35] to do dentistry at King’s again, and a month before I started my [00:12:40] first year, I got a letter from King’s. We were part of the first group at the time [00:12:45] in UK, which King’s was trialling for their four year dental programme, so I actually got straight [00:12:50] into the second year of dentistry. Now that programme is a graduate entry which a lot of universities are doing, but [00:12:55] I was the first batch that got selected for that. So basically I saved the year. I got a year back from, from, you [00:13:00] know, the years I wasted.

Speaker3: So it’s kind of you skipped the whole biochem physiology [00:13:05] anatomy piece. Yeah.

Speaker1: Basically. Yeah. So I skipped all of that and went straight into second year. Anatomy of the head and neck [00:13:10] scaling, giving each other ID blocks, all that. Yeah.

Speaker3: And so do I take it. In [00:13:15] this period you were still doing the music and you said DJing [00:13:20] and all that.

Speaker4: Yeah.

Speaker1: So I was still performing. So I had [00:13:25] my first taste of, uh, performance in rock bands at school, which I, which I really, really loved. It [00:13:30] was like one of the best experiences ever, uh, for me at the time. And, um, so and [00:13:35] when I went to uni, I was still doing, I was playing gigs, you know, guitar, like open mic nights. [00:13:40] We had a few band nights where I was performing with the guitar, um, and then in 2004. [00:13:45] So yeah, midway through the biomedical science degree, I got interested in DJing. So I [00:13:50] actually went to Iran one summer. I had a friend there who was a DJ who taught me basic beat matching, and [00:13:55] then I picked that up and came back to London. And I also had a part time job [00:14:00] as a student, as an event organiser. So we used to do sort of, um, parties, parties basically. [00:14:05] So I started DJing at our own parties slowly, slowly, and then yeah, picked [00:14:10] it up from there. And then I became a prolific DJ while I was at university [00:14:15] and then later on as well.

Speaker3: So are you just one of these successful [00:14:20] human beings who works hard, plays hard, like, can you pull it off? Because in my life I [00:14:25] think of like maybe three people who like, good at everything, [00:14:30] you know, or did it distract you and you failed? And what happened?

Speaker1: No, [00:14:35] actually, for some reason, I’ve always been very good at pulling [00:14:40] off, uh, exams last minute. So I remember when I was in dental school, I was literally promoting [00:14:45] like few parties a week, and I used to invite people that were studying dentistry and they were like, how do you get time? How do you [00:14:50] get time? But for some reason, I’m more of a practical learner. I used to pick up a lot in clinics. [00:14:55] I used to fall asleep in lectures, but then, you know, three, four weeks before [00:15:00] the exam, I’d lock myself in my room, I’d grow a beard and and just literally, like, suffer [00:15:05] and cram everything. And I used to do quite well in the exams, so, um. So. [00:15:10] Yeah.

Speaker3: So, so then you’re saying dental school? You found it. Okay. You didn’t find it [00:15:15] too difficult. You enjoyed yourself. You had a wonderful time.

Speaker1: Yeah. Dental school was good. I mean, I didn’t. [00:15:20] My socialising in dental school mainly was on the outside because I had this whole [00:15:25] other life as this, uh, sort of event organiser, DJ but, um, I did socialise with some [00:15:30] people from dental school and I had a great time there. Yeah. I mean it was, it was fun. I used to enjoy [00:15:35] clinics. I really like the practical side of dentistry and yeah, it went [00:15:40] it all went well. Really?

Speaker4: Yeah.

Speaker3: I’m thinking about it, dude. Yeah. Like this sort of. I know what Tehran’s [00:15:45] like. Yeah. And and the combination of the street smart [00:15:50] that Tehran gives you. Yeah. And dental school and [00:15:55] DJing and all that. So do you recognise that period in your life that five, six years [00:16:00] in your life in, in Iran as a period where you really learned about people?

Speaker1: I would [00:16:05] say 100% like the just exactly as you say, the street smarts that you pick up. And Iran [00:16:10] is just something else compared to like when I came back to London, I was just, yeah, you’re on Toytown. [00:16:15]

Speaker4: Yeah, yeah, yeah, I mean, I remember.

Speaker1: And and even the education [00:16:20] system, like when I came back, my sciences were at such a high level in Iran that I didn’t I [00:16:25] literally didn’t study at all in my GCSEs, like, and I aced everything. Just just from what I [00:16:30] got from Iran, the.

Speaker3: Standard was higher.

Speaker4: There. Yeah.

Speaker1: Much higher sciences standards, much, much higher physics, [00:16:35] chemistry, biology, like this stuff are just literally maths. I just aced it without even opening [00:16:40] a barely opening a book. So. So yeah.

Speaker3: So. Okay, you did your [00:16:45] degree.

Speaker4: And then.

Speaker3: What did you.

Speaker4: Do?

Speaker1: So yeah, I [00:16:50] finished dental school. At the time I wanted to do it in London. But, [00:16:55] um, again, the year that I went for my interviews was the first [00:17:00] year that they introduced this sort of ranking system and national interviews, and [00:17:05] I got advice from a guy in the year above me. I was like, so what do I do when I go for these interviews? They’re [00:17:10] like, oh, just be yourself, you know, get on with the trainer. If they like you, they’ll they’ll let you in. So I [00:17:15] go sit in the interview, just, you know, completely unprepared. And they’re asking me, so what do you know about the [00:17:20] 7 or 8 pillars of clinical governance or whatever it was? And I was like, uh, what’s clinical [00:17:25] governance? So, so basically, I didn’t rank very well in my interviews. And I ended up [00:17:30] in the West Midlands in, uh, in a sleepy town called Stourport on Severn, uh, [00:17:35] for my, uh, which was actually a great experience, uh, because it [00:17:40] got me out of London, which I think is good. Uh, yeah. It’s good to go and see somewhere else. And, [00:17:45] um, it was a it was a really, really nice practice. Lovely trainer, [00:17:50] you know, completely. I had people in London, you know, they’d get pressurised to do certain things, hit certain [00:17:55] targets. This was like complete clinical freedom. No pressure. Really, really nice training environment. I used [00:18:00] to come back to London every weekend though, but so cool. Yeah, but [00:18:05] but but no, it was a great year and um, I so I did that year and uh, for my [00:18:10] second year, I did a Showmax job in Northwick Park Hospital in [00:18:15] London.

Speaker4: Yeah. Wow.

Speaker1: And back then they used to call that place the jungle, because [00:18:20] he’s used to be very, very disorganised and messy and [00:18:25] busy.

Speaker3: Busy hospital, isn’t it? Yeah.

Speaker1: Like full on, full on district general. [00:18:30]

Speaker4: Yeah.

Speaker3: I have to go there. I have to go there sometimes. Um, and, um, [00:18:35] I always, every time I go there, I just think, man, everyone’s working so hard here [00:18:40] down to the Costa, you know, like everyone’s working their butts off and [00:18:45] the building, just like they. There isn’t even any way of maintaining that thing, right? It’s like it’s [00:18:50] so huge. It’s kind of I don’t know what’s gonna like. They’re gonna have to just, like, start all over again. [00:18:55]

Speaker4: Yeah, yeah.

Speaker1: It’s crazy. I mean, I’ve heard from the more recent, um, [00:19:00] sort of df2 shows that that it’s a lot better organised now, but, but, [00:19:05] but when, when I started, it was, you know, my first rotation was in A&E and [00:19:10] I remember for the, for the first probably 3 or 4 months every [00:19:15] day, I used to come back and go on the BJ jobs looking for associate jobs. I was like, I’m gonna quit, I’m gonna quit. It [00:19:20] was. But I have to say.

Speaker4: Um, it made a.

Speaker3: Man of you, right?

Speaker1: 100%. [00:19:25] It’s literally like going to the Army. It’s like, you know, like when they send the boys to army, it’s it’s [00:19:30] it’s it was hands down the hardest year of my professional life and probably the most valuable year [00:19:35] of my professional life.

Speaker3: So you were you were stitching faces up in A&E and then [00:19:40] assisting in big operations.

Speaker4: Trauma, cancer. So all of that.

Speaker1: So yeah. So I’ll [00:19:45] tell you a quick story about my first. It was my third day on my A&E rotation. I get a Bleep from [00:19:50] A&E and um, they’re like there’s a girl that was giving blood who fainted and [00:19:55] cut herself. So I walk into the room and she’s sitting there, a pretty 19 year old Iraqi girl [00:20:00] with a gauze on her forehead. And I’m like, okay, so what happened? She was, yeah, I was giving [00:20:05] blood. Blood. And then she takes the gauze off and I’m literally staring at her frontal bone. Like I can literally [00:20:10] see the front like a big laceration all the way down to her eyebrow. Wow. So I look at that [00:20:15] swallow and I’m like, just give me a minute. I’ll be back, run outside, call my SPR. I’m like [00:20:20] literally shaking. Like, oh my God, there’s a girl here. She’s got a laceration. I can see her frontal bone. And [00:20:25] he’s like, okay, stitch it up. Boom. Puts the phone down. So so [00:20:30] I’m like, okay. So I go back in there again, I’m like, let me see that [00:20:35] again. I look at it and I was about to stitch it. But then in my head I’m thinking, I’ve just come [00:20:40] out of dental school. This is a 19 year old girl. She’s got a whole life ahead of her. She needs to get married. I’m [00:20:45] going to literally make her look like Frankenstein.

Speaker4: Yeah.

Speaker1: So so I basically [00:20:50] went like, went to the department and I was like, I refuse. I’m like, I’m not going to do this. Which is a good decision. Svr [00:20:55] came did it cut? A long story short, fast forward to the end of the year. I was stitching up lacerations [00:21:00] like that, you know, like it was nothing. You know, open, open jaws, like, [00:21:05] you name it. And just just once you go back to practice after doing that, [00:21:10] teeth just seem like a doddle. Like, you know, it’s like, oh, it’s just a tooth, you know?

Speaker4: Nothing.

Speaker3: Nothing fazes you. [00:21:15]

Speaker1: Yeah. Like the cancer surgeries, raising flaps off, you know, various parts of the body, like [00:21:20] just. Yeah, it’s. I would strongly recommend it, even if you don’t want to specialise to anyone who [00:21:25] just wants to be a very confident dentist with. Excuse my language balls.

Speaker4: Exactly. [00:21:30]

Speaker1: Yeah, yeah.

Speaker3: Yeah, I did a job in Cardiff Royal Infirmary [00:21:35] and, um, if there was a rugby game on. Yeah. And there was [00:21:40] many rugby games on if it was Wales. England. Yeah. There would be just massive [00:21:45] number of like, you know, pint glasses smashed in people’s faces, like, [00:21:50] you know, bouncers. Bouncers have a lot to answer for here because the number of people at 3 a.m. [00:21:55] that would come in and say, bouncer, beat me up and say why? And they would go, no.

Speaker4: Exactly. [00:22:00] That’s why.

Speaker3: But if it was the [00:22:05] game, if it was a Wales Scotland game, there wouldn’t be anything like that. Really friendly, [00:22:10] you know. Yeah, but I know what you mean about making Man of You because I hated that job. [00:22:15] But it did make a man of me. Did you do it on purpose because you knew you [00:22:20] had to specialise?

Speaker4: Yeah, basically.

Speaker1: Yeah, I wanted to. I wanted to leave at that [00:22:25] point again, I was I hadn’t made my mind up 100% that I’m going to specialise, but [00:22:30] I wanted to leave the doors open. And at that time they were like, you know, you have to do a sort of show job. [00:22:35] So. So I went for that.

Speaker3: So. So what was your next move?

Speaker1: So next move was [00:22:40] I came to practice in London. I started working at three practices actually [00:22:45] as a GDP, and one of them was a sedation referral centre. So I picked up IV sedation pretty [00:22:50] quickly. I was using my max FAC skills, so I became quite good and interested at [00:22:55] oral surgery. I still would consider myself as having a special interest in oral surgery. I still do quite, you know, bits [00:23:00] of it here and there. And so I was doing sort of referral work for IV [00:23:05] sedation, oral surgery and then just mainly it was mixed, but [00:23:10] mainly NHS at the time. And then I did various courses. [00:23:15] I got interested a bit in short terme also like aligners and also [00:23:20] implants. I became quite interested in. I did a couple of courses in implants and that’s the direction [00:23:25] I wanted to go in. Initially. The reason I didn’t go down that direction was [00:23:30] I, after doing the courses, the practices that I worked in, they the principles [00:23:35] were implant dentists. So I found that I wasn’t getting the volume of work. [00:23:40] And you know, if you want to get good at something, you have to do a lot of it. And, um, [00:23:45] you know, it just wasn’t getting the volume of work that I needed. So, um, I was like, okay, [00:23:50] I need to, I need to go and specialise in something. So I [00:23:55] thought I was at one point going to go specialise in oral surgery. I did actually apply. I didn’t get in. [00:24:00] And then eventually I went back to Endo and [00:24:05] um, I decided to go for Endo and that was four years into being [00:24:10] in practice. So I practised for four years as a as a general dentist. And [00:24:15] then I got into my, uh, four year part time specialist training back at Guy’s [00:24:20] in wait.

Speaker4: Wait wait wait wait.

Speaker3: Before you go any further, though, in that four years is still you knew [00:24:25] you were going to specialise. Dope or not or not? I guess you were starting to [00:24:30] make some money now.

Speaker1: Yeah, exactly. So? So I wanted to. So that’s the thing. So yeah, my next [00:24:35] goal was to buy a property. So like, all my friends, you know, my friends have done three year degrees. They’re already miles ahead [00:24:40] of me. And they were they already had their properties. And I was like, I need to save and buy a property. So, you know, I lived [00:24:45] with my mum for a few few years, saved some money, bought a flat and um, [00:24:50] and then, yeah, I, I really hated the fact the prospect [00:24:55] of going to study again. Like, I’m not someone who typically enjoys studying and exams. I hate [00:25:00] exams, so. So, you know, just actually deciding to go back and put myself [00:25:05] through that was a big decision. And, um, and I was reluctant to [00:25:10] do it. But I suppose another reason why I ended up doing it as well was I really [00:25:15] wanted to get out of the NHS system, because I really didn’t like the NHS system. Um. [00:25:20] Yeah.

Speaker3: So then when you were looking at post-grad, the [00:25:25] calculations that you’re making are, you know, money calculations, [00:25:30] time calculations, is this whole thing going to be worth it in the end? And [00:25:35] you never really know whether you’re going to be, like, happy as an endodontist until you become an endodontist. [00:25:40] I mean, there’s that sort of four years of is it four year course?

Speaker4: It’s either [00:25:45] part.

Speaker3: Time.

Speaker1: It’s four year part time or three year full time.

Speaker4: Yeah.

Speaker3: You did four years part time. [00:25:50]

Speaker1: I did four years part time.

Speaker3: So you continuing as an associate in in these practices while [00:25:55] you did. So tell me about that life man. Is is that do you recommend that or. Now if someone came [00:26:00] to you would you say, listen, just drop everything. Do three years full on.

Speaker1: I would 100% [00:26:05] recommend four year part time.

Speaker4: And pay for your.

Speaker3: Life and stuff.

Speaker1: No, that [00:26:10] is part of it. But even if you have the money, you learn certain skills in hospital. [00:26:15] But hospitals are protected. Environment, right? So you try something, you know, you create a [00:26:20] ledge perforation, whatever you try and fix it, try 1 or 2 times. You can’t do it. You call [00:26:25] over the supervisor, he does it for you, right? You watch what he does, you pick it up, practices you where you [00:26:30] really you know, you’re in the deep end like some whatever happens, you have to deal with it, [00:26:35] right? So that’s when you really, really, in my opinion, hone the tips and tricks [00:26:40] that you pick up in hospital. And also in terms of getting jobs, like I started [00:26:45] off as an NHS GDP, I got my first endo referral job [00:26:50] midway through my first year. By the end of my second year, I had fully [00:26:55] given up general practice and I was working only sort of in endo referral practice. So I, [00:27:00] you know, so, so, so, so you so you hit the ground running massively like, you know, you’re already there’s [00:27:05] no transition. Like, you know, when you finish your specialist training, you’re already a specialist. You’ve been working as that. And [00:27:10] you know there’s no jump to make. It’s you’re there basically like.

Speaker3: In a way you’re like dentists [00:27:15] with special interests kind of thing while you’re studying. It’s interesting. Yeah, it’s a very good point, actually. [00:27:20] It’s a very good point. Um, so, so, so then the course itself, what [00:27:25] was the commitment to the course like? How much work was it? How many times do you have to turn up? What was what was the story. [00:27:30]

Speaker1: So in the first, uh, year, it’s three days a week because [00:27:35] you have up until sort of the middle of the second year. So the first one and a half years is about three days [00:27:40] a week. You’ve got seminars got to go to and then clinics. Clinics are two [00:27:45] days a week. Then from about midway through the second year, for the last two and a half years, it’s just two days a [00:27:50] week of mainly clinics. Sometimes you have seminars on a Friday as well. So it’s like you have to [00:27:55] go in on the odd seminar here and there. This is, by the way, the program at guy’s, the people who did it at the [00:28:00] Eastman, The Commitments a lot more because they’re a lot more academic there. So, you know, they have to [00:28:05] go in a lot more journal clubs at guy’s. The system is you sort of put [00:28:10] in what you want to take out, and a lot of it’s down to you, you know, they tell you what you have to read and you read [00:28:15] it in your own time. Um, so, so for me, again, being the last minute [00:28:20] person I am, I generally left things all to the last minute, which I wouldn’t recommend. Um, [00:28:25] now a clinical teacher. So I’ve got, you know, I’ve been teaching on the department for just over, oh, just over four [00:28:30] years. And I don’t recommend any of my students to do it that way, but it’s incredibly stressful. But that’s the way [00:28:35] I did it.

Speaker3: And at what point in that in that time? I mean, it [00:28:40] seems like a long, long time to teach Endo. And by the way, I know there’s [00:28:45] more to endo than Endo, right? That you’ve got all the apes ectomy piece and all that. Right? [00:28:50] Um, but at what point in that time does something click in your head? Is it early? Something [00:28:55] like clicks in your head, like endo clicks for you. Like you [00:29:00] feel like I know what’s going on. Is it early or is it late?

Speaker1: I think it’s [00:29:05] early. Like as soon as you pick up that microscope and you realise, you know, it’s like a [00:29:10] whole, it’s like, you know, picking up a telescope and looking into space, like, until you’ve worked with [00:29:15] a microscope, you don’t know what you don’t see. Like, you think, you know, even even something as basic as caries [00:29:20] removal. You think you remove the caries, but then you get under the microscope and you see what you really, [00:29:25] you know, leave behind. And it’s just it just elevates your practice to such [00:29:30] a different level. I literally I work exclusively with a microscope. I can’t even look into [00:29:35] a patient’s mouth without a microscope now. Like, even if it’s a check-up, I use a microscope. I don’t feel [00:29:40] confident looking in a patient’s mouth without a microscope. That’s because of the level of detail [00:29:45] I’m used to looking at. Um, and so.

Speaker3: If I want you to work with my practice, I absolutely [00:29:50] have to have a microscope. There’s no there’s no getting away from that.

Speaker4: No chance.

Speaker1: No chance. [00:29:55]

Speaker4: I.

Speaker1: Don’t yeah. No chance. Yeah. And I get and I get that offer as well. You know people who want to set up you know they [00:30:00] want to set up a low cost sort of level. They say, you know, can you start off until we build up the list. But [00:30:05] on my I, in my humble opinion, high level specialist endodontic [00:30:10] treatment is not possible without a microscope. And that is. And it doesn’t mean that you can’t. [00:30:15] You know, a lot of people work with loops and you can do, you know, many cases with loops, [00:30:20] but, you know, if you really want to provide a specialist service, when it comes down to it, that [00:30:25] tiny MM2 we split off, you know, a few millimetres down the hm1 or, you know, that instrument [00:30:30] which is broken and down in the root, you know, the real high level, that little crack that might [00:30:35] be on the root when you’re doing this, these things, you know, you really need a microscope. It’s not possible to do the service without a microscope. [00:30:40] And there’s so much more to endo than what people think. I mean, you can go into that if you want.

Speaker4: But. [00:30:45]

Speaker1: Yeah. So I mean, the first thing I would say that, [00:30:50] uh, you know, the first let’s say super power of endodontist is diagnosis, [00:30:55] okay. Amongst the specialists when it comes to dental pain, the [00:31:00] expert is an endodontist. So anyone who’s got any sort of pain in the head and [00:31:05] neck region that might be, you know, related to the mouth, should initially always see an endodontist to either [00:31:10] confirm or exclude dental pain. And when you get confident at diagnosis, it [00:31:15] just again, it just elevates you to this level and of of of I don’t know of [00:31:20] of confidence. Um, because you know, you can’t how can you treat something if you can’t diagnose [00:31:25] it. Right. And I have to say again, unfortunately, the majority of dentists [00:31:30] and doctors are actually not good at diagnosis. So again, if we just go [00:31:35] to sort of GP’s, you know, you go to the GP, I’ve got a sore throat, I’ve got this or [00:31:40] that. Here you go. There’s some antibiotics okay. And there’s nothing. And by the way there’s no there’s [00:31:45] no sort of mystery about diagnosis or anything that needs special skill that I have that someone else doesn’t. It’s [00:31:50] all the basic stuff. Everyone knows this. The skills that I use for diagnosis, apart [00:31:55] from possibly the microscope and cbct everyone learns as an undergraduate, [00:32:00] it’s just no one actually takes the time to meticulously go through all of those investigations [00:32:05] and special tests to come to that diagnosis.

Speaker1: And as an endodontist, you know, I book, [00:32:10] if someone comes to me for a pain diagnosis, the appointment might take one hour. You know, I will spend. [00:32:15] Depending on how complex it is, I’ll spend all the time, you know, to check every tooth to come to that diagnosis. So the first thing [00:32:20] is that, you know, accurate diagnosis and there’s so many complaints. So, so many, [00:32:25] um, issues regarding poor diagnosis and which, you know, people have gone they’ve ended up having [00:32:30] treatment which hasn’t worked because the diagnosis wasn’t correct. So the first part is diagnosis. And, [00:32:35] you know, by by exclusion, we’re also good at diagnosing non-dental issues. So [00:32:40] it’s things like atypical facial pain. You know I diagnosed some of them obviously, if I suspect that I refer [00:32:45] to an oral medicine consultant or a for formal diagnosis, but that’s the first, [00:32:50] um, sort of super skill that I would say an Endodontist possesses. Then, um, [00:32:55] moving on, obviously there’s there’s the root canal treatment itself, which is treating the canals. [00:33:00] Um, again, as I said, magnification is one thing. Um, the tactile sensation is [00:33:05] the other thing. Feel comes a lot into it, which we know about. And of course, sorry, [00:33:10] just my, um.

Speaker4: My cough already. And, [00:33:15] and, um, and.

Speaker1: Yeah, I mean, then then there’s a whole surgical side of it, [00:33:20] which I’m very interested in, given my background in, uh, oral and maxillofacial [00:33:25] surgery. There’s a surgical side of it. And the restorative side. Don’t forget most of the teeth. That or many [00:33:30] of the teeth that I get referred are broken down teeth, broken down teeth, which dentists [00:33:35] themselves can’t restore because the margin might be at the crestal level. I always, [00:33:40] before I attempted endo, completely build up the tooth first, so the tooth has to have a sound [00:33:45] four walled area for me to work in before I even consider it, you know, treatable [00:33:50] or restorable.

Speaker3: And that has to be your build up. You don’t you can’t trust someone else’s build up. [00:33:55]

Speaker4: Is going to be euro is.

Speaker1: Is unless I’m working with, um, you know, a dentist, [00:34:00] which I know is very skilled. And there are a lot of dentists now. Dentists. So, you know, they’re both, you [00:34:05] know, Prosthodontist and GP’s. I work with some very, very talented GP’s, some of them who are working with microscopes [00:34:10] now as well, I have to say, and you know, they do fantastic work and um, unless I know the GP’s, [00:34:15] um, you know, fantastic at doing that. Um, all, all I need though, I need [00:34:20] obviously that we need to have enough of the sort of two structure to, uh, get adequate isolation [00:34:25] because you don’t want the tooth to be reinfected. There are some dentists who have like, a deep margin and they’re [00:34:30] doing a root canal. You can’t have that because it’s getting it contaminated by saliva. But yeah, but but [00:34:35] generally, yes, I will take charge and I will do the full core build up which, which the GDP [00:34:40] is majority love as well. I send the tooth back always with a composite core, ready [00:34:45] for them to just cut the margin and put a crown on it.

Speaker3: And so look, it’s quite interesting [00:34:50] isn’t it? Because you must the general dentist who does Endo [00:34:55] must be getting better at it because of rotary instruments. And all of [00:35:00] that is I mean, endo has done it to much higher standard by general dentists than it ever used to be in my day, when it was hand [00:35:05] instruments. Right at the same time, there’s loads of dentists who just choose not [00:35:10] to do endo at all. Um, and I guess that number’s increasing too, right? So [00:35:15] you must the referrals must be like two types, like one very difficult [00:35:20] type because, you know, the general dentist didn’t manage it because and then you’ve got the basic ones. Right. [00:35:25] So, so when it comes to your week. How often [00:35:30] do you end up in a situation where, like, you know, you’re not sure which way [00:35:35] to go or.

Speaker1: Yeah. I mean, you know what? You hit the nail on the head. That’s exactly it. You know, you’ve [00:35:40] got the mixture of cases. You’ve got dentists who don’t do root canals at all, who send you these lovely [00:35:45] primary endos which are then. Yeah, that’s that’s an easy, smooth day. [00:35:50] And then I’ve only got the ones who attempt an end render, cause a couple of perforations. [00:35:55]

Speaker4: And then send you the case.

Speaker1: And think you’re gonna the magician’s gonna fix it. [00:36:00] So. So, yeah, I mean, I get a mixed bag of those and, you know, it’s just it’s just the whole swings [00:36:05] and roundabouts things, right? So you get you get the easy ones, which you just breeze through and then you get the more difficult [00:36:10] ones which you. Yeah.

Speaker4: But what is the what.

Speaker3: Is a very difficult case to you. Is that, is that really [00:36:15] it. Perforations you have to repair.

Speaker1: No I would say probably the most [00:36:20] difficult error. So one difficult case that I would get is um, uh, [00:36:25] maybe like a very curved root, which has been very badly ledged. [00:36:30] Um, yeah. So, so if, if a tooth, if a, if a root is very curved [00:36:35] sometimes even for, you know, the endodontist, we have to be very, very careful not to ledge it. [00:36:40] And then you got the GDP. Who goes in with like a something big, like a size 25 K file basically [00:36:45] completely ledges that canal. And then we have to go around and fix it. In those cases, you know, sometimes it’s [00:36:50] near near impossible to fix. Again, as endodontists, um, we’ve got different skill sets. It depends [00:36:55] where that root is. If it’s a typically it’s a root of a upper molar, in which case [00:37:00] if you really can’t fix it, you just do an episiotomy and just cut that curved part off and that’s it. You can still we’ve got, [00:37:05] you know, we’ve got all sorts of ways of retaining teeth these days.

Speaker4: So and then.

Speaker3: How, [00:37:10] how, how can you like add value as an endodontist. I mean what’s, what’s what’s a [00:37:15] great endodontist and what’s a not great end if I, if I’m referring to three different endodontist [00:37:20] versus where’s your value add. Is it in the soft skills as well?

Speaker4: Absolutely. [00:37:25]

Speaker1: I think the I think a big part of being uh, well, both [00:37:30] a good dentist, but especially an endodontist comes down to psychology. That’s actually probably [00:37:35] one of the parts of the job that I enjoy the most. So, you know, [00:37:40] as a, as a general dentist or other specialists, you know, you get to meet the patient a number of times, [00:37:45] build the rapport with them. Um, I always joke and those like a one night stand, you [00:37:50] a patient comes in and, you know, often they’ve met you, you know, [00:37:55] either met you once or not met you at all. Most, most times. And, you know, they all come in with [00:38:00] this terrible, um, you know, uh, terrible idea or preconception of [00:38:05] of of, uh, of. Yeah. Then they come in nervous because or they’ve all heard, [00:38:10] you know, horror stories about endo and, you know, root canal is really painful and, you know, so so they come [00:38:15] in scared and you’ve got to, in a very short space of time, build that rapport with them [00:38:20] to calm them down, to, number one, accept the treatment. And it is, I think, the greatest [00:38:25] compliment when you know, if you finish the treatment, you take the rubber dam off. Either [00:38:30] the patient was snoring when the rubber dam was on. That’s that’s, that’s that’s that’s one of the compliments. Um, and [00:38:35] number two, which I hear very often is, oh my God, that really wasn’t as [00:38:40] bad as I thought it would be. Thank you very much.

Speaker4: But but is.

Speaker3: That is that because you are so kind [00:38:45] or is it because you’re doing something differently?

Speaker1: So let me let me in my opinion, [00:38:50] the reason why Endo is, has got this stigma around it, right is because [00:38:55] we know and it’s difficult, right? It’s it’s even me without a microscope, [00:39:00] looking into that dark hole and trying to find canals is difficult. Right. So patients [00:39:05] so dentists, most endo in the world is done by general dentists and they don’t have microscopes and [00:39:10] barely some of them don’t have magnification. So when the dentist sees the patient the dentist [00:39:15] is already, you know, a bit nervous and you know, the struggling a little bit. And I think the [00:39:20] patients, you know, our patients perceive are or they sense our, um, our, [00:39:25] our psychological state and how anxious we are a lot more than what we think. So, [00:39:30] um, you know, if a dentist is struggling and quite often, you know, they want numb the patient [00:39:35] very well or won’t take the time to numb the patient very well. So the treatment will be painful for the dentist, but [00:39:40] for the patient, sorry. And the dentist will be, you know, anxious and struggling while they’re doing the treatment. And the patient senses [00:39:45] that. And then afterwards, if something’s not done right, um, a patient will be in pain. [00:39:50] So there’s all sorts of this sort of perfect storm of things which add, add to [00:39:55] this bad experience. And that’s why Endo’s got this bad reputation, and then it goes wrong and the tooth [00:40:00] has to get extracted after all of that.

Speaker1: Right? So when you when you come to a specialist, you’re coming to someone who does this every [00:40:05] single day. So first of all, I’m very, very calm. And I have to say endo is [00:40:10] also a very it’s it’s connected to the psyche of the, the endodontist as [00:40:15] well. If one day, for whatever reason, I’m not calm, my treatment will not go [00:40:20] as smoothly as the days that I am calm. So I work a lot on myself to be very, very relaxed. When I’m seeing my patients, [00:40:25] you know, I’ll, I’ll go to the gym in the morning. I’ll do breathing. Sizes, you know, [00:40:30] even while I’m treating, you know, deep breaths. Very, very important. Like, if anything’s, you know, you have [00:40:35] to you have to master the art of patience, uh, as an endodontist and and just [00:40:40] giving that, uh, you know, giving that smooth experience to the patient, um, is, and, you know, [00:40:45] they can sense it. They can sense your calm. You’ve got the rubber dam there, you know, they’re relaxed. Are [00:40:50] you numbing up? Well, good anaesthesia is the other thing which is very, very important. So, you know, I take my time, [00:40:55] um, to numb patients up. I’ve got various techniques that I go through to.

Speaker4: Make sure I’ve been.

Speaker3: I’ve [00:41:00] been out of it for a while. Um, but in my day, you know, if if your le didn’t work [00:41:05] for a hot pulp, I guess you’d give another one first. The first thing [00:41:10] you do. And then there was the inter ligamental intraosseous as something changed.

Speaker4: No, [00:41:15] that’s more or less it.

Speaker1: Really. You want to give obviously an effective ID block, which we all know how that works. [00:41:20] Um, you give your um, depending on where the tooth is. Obviously we’re talking about lower tooth here. You know, your long buccal lingual [00:41:25] infiltration, intra ligamentous work really well. Um, intraosseous. But if it’s a [00:41:30] very, very, very hot pulp in some cases, whereas, you know, lots of inflammation or whatever you do that [00:41:35] LA is not getting there. What you do is you basically have to you have to again, it’s all about communication. [00:41:40] You tell the patient, look, you’re going to feel a little sharp, a pinch here. You basically enter the pulp. [00:41:45] They go out. And then as soon as as soon as you see that drop of blood, say, okay, I’m going [00:41:50] to numb you up now directly through the nerve, you’re going to feel one more pinch. And after that, you’re not going to feel anything. Put [00:41:55] the needle in with a lot of pressure. Give that anaesthetic directly into the pub. They’ll just feel [00:42:00] one pinch. And after that, intra pulp will works very, very effective for pulps. So [00:42:05] that’s that’s the, that’s the that’s the final straw. The intra pulpal.

Speaker3: With a lot of pressure. You [00:42:10] wouldn’t think a lot of pressure.

Speaker4: Yeah.

Speaker1: Yeah yeah. Because because there’s a lot of information there. And and and [00:42:15] you want to give that with quite a bit of pressure in the pulp.

Speaker3: Is there, is there ever like [00:42:20] ever a time where you put something on it to settle it down or is that not a thing anymore. Let [00:42:25] it mix whatever it was.

Speaker4: Oh yeah.

Speaker1: Yeah. So so now we’re talking. Yeah. If it’s like just emergency management then yeah. [00:42:30] Once you’ve exposed the pulp, for example, you can put something like leather mix or add onto paste. These have both [00:42:35] got uh um steroid and anti antibiotic component to them. And then yeah you can go back and go [00:42:40] go back in again. But as an endodontist most often you know we’re doing all of this in sort of one session. [00:42:45] We do the pulp, we open up the pulp, we go and we do the end of most 90% of my endos are [00:42:50] single visit. So.

Speaker3: And why? Because that for because of contamination. [00:42:55]

Speaker1: I mean it’s it’s so.

Speaker3: It’s more efficient I guess. Yeah.

Speaker4: I mean it’s. [00:43:00]

Speaker1: I mean who wants to have a root canal twice. It’s more it’s and it’s, it’s more efficient. And there’s been [00:43:05] countless studies including cup 2 or 3 I think Cochrane reviews, which are [00:43:10] like the highest level of evidence on the outcome of single versus multiple visit endo. And there’s [00:43:15] basically no difference. So if you can do it in one visit, why don’t you do it in one visit? Just do it. Yeah. So so [00:43:20] if I can do it in one, unless there’s a big reason why I can’t do it in one visit, I’ll do it in one visit. [00:43:25]

Speaker3: And I’ve noticed for my sins I follow some endodontists. Yeah, I’ve noticed that the access [00:43:30] cavities are just getting smaller and smaller and smaller. Is that is that like an endodontist like thing like that? [00:43:35] How small can you make your access?

Speaker1: Yeah, the the ninja.

Speaker4: Access is always cool. [00:43:40] Yeah.

Speaker1: So I mean, yeah, um, it’s, it has become a little bit [00:43:45] of a trend and of course, look, conserving dentine is important, but the thing I [00:43:50] don’t like is when my postgrads come, you know, their first year postgraduate specialist training [00:43:55] and they’re doing a tiny access because they saw, you know, the endodontists do that on Instagram and I’m like, [00:44:00] look.

Speaker4: Learn, learn to walk before you fly.

Speaker1: Run like, you know. And it’s [00:44:05] actually it can actually work against you, especially when you’re starting out because you know, [00:44:10] it can all sorts of procedural errors. It increases the risk of file fracture it. You [00:44:15] can leave, you know, bits of necrotic pulp in. So it’s definitely not something I would recommend or [00:44:20] do. I mean I if I can make a conservative access and I can do it without any compromise, [00:44:25] I will do it. But you know, the difference between the, those sort of ultra conservative access [00:44:30] is the difference between a conservative and an ultra conservative. Access in terms of long tum outcome [00:44:35] has not been proven to be to be, you know, significantly different. So a lot of that sort [00:44:40] of ultra conservative work is for, I don’t know, Instagram dentistry in my opinion. [00:44:45]

Speaker4: Yeah.

Speaker3: And we have it in every field. Yeah.

Speaker4: But but but look.

Speaker1: I think, I think I think social [00:44:50] media is great for again I always joke with my students, um, on the clinic I [00:44:55] say before an endo, we used to have success and failure and now we’ve got success, failure and Instagram [00:45:00] Insta.

Speaker4: Instagrams like them.

Speaker1: At the highest level. When when the case is Instagrammable, [00:45:05] it means, you know, it’s it’s it’s perfect. So it’s the category above success. [00:45:10]

Speaker4: It’s funny man.

Speaker3: Yeah. But and you know getting on to that most [00:45:15] dentists who post on Instagram are posting for patients. But you [00:45:20] guys are posting for dentists.

Speaker1: Yeah, that’s absolutely right.

Speaker4: Um, you know, it’s a.

Speaker3: Different it’s [00:45:25] a totally different way of doing it. Right. Because when you’re posting for patients. The, you know, people, [00:45:30] people, people often confuse this. They say, oh, I’ve seen it before and after, but I don’t see the bit [00:45:35] in the middle. Well, the patient doesn’t want to see the bit in the middle, right. Yeah, yeah. Um, but on your side, if [00:45:40] you suffer with sort of that perfection and that paralysis like you [00:45:45] have to worry about, I don’t want to put this out because my endodontic buddy might see something.

Speaker1: And [00:45:50] yeah, I think everyone who posts on Instagram has, has, has that. I mean, as [00:45:55] an as an endodontist you have that anyway you get you develop um, OCD, you know, I’ll [00:46:00] look at I’ll look at my cases and they’ll be like a little void somewhere. And, you know, I’ll be pissed off for [00:46:05] the.

Speaker4: Rest of the day, you know.

Speaker1: So, so which is not good.

Speaker4: I mean, it’s not.

Speaker1: And [00:46:10] again, we always teach it’s not about the why. And, you know, you have an ender which looks horrible and it’s [00:46:15] been there for 30 years with no lesion. And then you have an ender which looks perfect and it fails. So [00:46:20] it’s not really the white lines aren’t everything. You know, we’re dealing with bacteria and we have to prioritise the biology [00:46:25] over the, you know, our own sort of perfectionist, uh, aspirations. But yeah, absolutely. [00:46:30] You know, especially when it comes to posting, you know, you always want to post that case. I mean with me, I’ve, I’ve, [00:46:35] I was never a social media person. Um, I got sort of my arm got twisted [00:46:40] into it by, by Rona and uh, and.

Speaker4: And.

Speaker1: And and and another one of my colleagues, [00:46:45] Karina, who’s, uh, in, you know, big on Instagram and she’s a dentist. And, you know, they were [00:46:50] like, look, you know, you need to do this. So I only started my account about, I think, three years ago. And [00:46:55] I need to I know I’m always saving cases to post, but I don’t I don’t post anywhere near as much [00:47:00] as I should. Um, yeah. So yeah.

Speaker3: When, you know, [00:47:05] um, when you work in eight different practices. You [00:47:10] see a lot of different ways of running a practice.

Speaker4: Yeah.

Speaker3: And, [00:47:15] you know, good and bad, right?

Speaker4: Absolutely.

Speaker3: And I’m sure you love [00:47:20] all your referrers. But. But tell me. Just give me a flavour of that. I mean, I [00:47:25] obviously I go to a lot of practices, so I see that myself, but I can’t really get [00:47:30] a real feel for it by visiting a practice and talk about bleaching. But when you work [00:47:35] somewhere, you really get a feel for the management style. [00:47:40] What are they willing to spend? What aren’t they willing to spend the way they handle patients [00:47:45] staff? Give me give me a flavour of the differences in different practices [00:47:50] and what you’ve learned.

Speaker1: Yeah, you’re 100% right. And I have to say, you know, the eight [00:47:55] practices that I’ve got now have probably been distilled from [00:48:00] something in the region of 2025 practices or more, maybe over the last, [00:48:05] God knows, five, six, seven years, which I’ve joined. And, you know, if I join a practice [00:48:10] and I don’t like the way it operates, I, you know, very respectfully sort of shake hands and bow [00:48:15] out, um, and, you know, what does that mean?

Speaker3: What does that mean? I don’t like the way it operates. I mean, [00:48:20] like, so I, you know, it could be as subtle as the way the nurse is treated [00:48:25] by the boss. You’re not going to bow out because of that, are you?

Speaker4: Um, yeah.

Speaker1: It’s everything. [00:48:30] So. So I start. So look a good the way a good practice is run. And, um, you know, the majority of practices [00:48:35] I work at now are well run. Um, you know, the. A reason why. [00:48:40] I used to work in a couple of practices which are bought by corporates, for example. And I think the, the, [00:48:45] the most important thing is a practice which is well run, has a principal who is [00:48:50] present and cares about the practice. I think no one will ever care about your business as [00:48:55] much as the business owner. And the practices which are really well run, have hands on owners. [00:49:00] You know that they’re on the ground, they’re making sure the staff are fine. They’re making sure all the materials [00:49:05] you need are there. They’re communicating with everyone you know. You can have the best practice manager in the world [00:49:10] and you know, that is that is also very effective because again, practice managers do wonderful jobs that I [00:49:15] think having a good practice manager is, is, you know, it’s like gold dust. But yeah, [00:49:20] it’s first of all how the how the practice owner runs the business themselves.

Speaker1: Then [00:49:25] it’s the staff. You know, for me personally, as someone who travels between so many surgeries, [00:49:30] having a good nurse is absolutely key. If if I’m working with a [00:49:35] nurse who doesn’t know where things are, for example, or, you know, has never done endo before, [00:49:40] which fortunately I rarely encounter these days, but you know, that will completely destroy my day [00:49:45] and not just destroy my day for my mood, but also reduce. You know, I I’ve [00:49:50] had to have this conversation with principals before who’ve, you know, not done what they’ve needed [00:49:55] to do to, for example, retain a good nurse. And I said, look, when you for [00:50:00] example, just just talking about me, if I’ve got a nurse who is not effective, I can’t [00:50:05] do all my endo’s in the single visit. Right? And I’m going to have to book a second visit to complete the endo. Just, [00:50:10] just one case of rebooking an endo is a loss to both me [00:50:15] and the practice enough to accommodate, you know, whatever you need to to have have that good nurse. So [00:50:20] a.

Speaker4: Good point.

Speaker1: Yeah. So so so you know you’ve got to think of it. And you know the nurses [00:50:25] are the backbone of every practice in my opinion. And and the practices which operate well [00:50:30] have good nurses, nurses who are both treated well. And it’s not hard to treat [00:50:35] a nurse well. Right. It’s just it’s just the little things like, you know, just be nice, you know, buy them lunch [00:50:40] every now and again. Give them a little gift here and there. Just be nice to them. Be courteous to them, you know. Don’t don’t. [00:50:45] They’re not they don’t they’re not your you know, they’re not your workers. They’re your they’re your colleagues. You know, that’s how you have [00:50:50] to treat them. And, and that sort of, you know, practices which operate well that really resonates [00:50:55] and practices which don’t, you know, people who just don’t care about the, you know, [00:51:00] the the staff and the nurses and, you know, you’ve got high turnover. You know, I walk in and you know, there’s a temp [00:51:05] there, I’m like, hi, how are you? My name is Aram. Have you ever done Endo before? Uh, I know I watched your [00:51:10] video on YouTube last night. It’s the first. And it’s like my heart sinks. I’m like, ah.

Speaker4: And [00:51:15] you know, that’s already.

Speaker1: A bad place for me to start my day. And, you know, like I said, you know, my psychological [00:51:20] state is very important on how my treatment goes and how I manage my patients. And, you know, starting the day that [00:51:25] way is, you know, not not the way that’s not going to work for anyone.

Speaker3: I mean, do you insist on the same nurse every time? [00:51:30] You should. Right.

Speaker4: Um, more or less.

Speaker1: I’ve got the same nurse in every practice. Yes. [00:51:35] I mean, there will be occasions where they’ll change and some practices have, um, you know, more than one nurse who [00:51:40] are sort of good enough to do the job. A lot of nurses don’t want to work with me. Not because, I mean, [00:51:45] I’m very, very nice to the nurses, but they just don’t like Hendo. It’s not obviously not very popular. I always joke and [00:51:50] I say, um, you know, the number one skill for endo nurse is to stay awake.

Speaker4: Um, so, [00:51:55] so.

Speaker1: Again, um, you know, some of the practices I work at, you know, my microscopes [00:52:00] got a camera attached and we’ve got a big TV, so the nurse actually can see what I’m doing, which is also [00:52:05] quite helpful. And, and one of the most important qualities, in my opinion, for a nurse is actually [00:52:10] being interested in what the dentist is doing. Like, you know, when, when the nurse is following what I’m doing, um, you know, [00:52:15] it just everything works a lot better. You know, they anticipate what I’m doing is sometimes they’ve got in their hand what [00:52:20] I’m already thinking about, you know?

Speaker4: So I think.

Speaker3: Look, um, I always, I often [00:52:25] talk about this idea of we’ve got, we’ve got some customers, right. And listeners who, [00:52:30] you know, the, the staff are completely empowered when, [00:52:35] when they’re making orders, you know, you say, hey, buy some more. And they just decide there and then themselves, [00:52:40] they say, yeah, buy, we’ll buy, we’ll double that order or whatever it is. And they don’t have to check with anyone. Yeah. And [00:52:45] interestingly, that same practice, those same practices pay their bills on [00:52:50] time. Um, they do a lot of whitening, you know, it’s a well-oiled machine, [00:52:55] a well-oiled machine. People are people are empowered to do things. And you can see it’s, you know, you [00:53:00] can imagine they’re good at a lot of different things. Yeah. Um, you’re 100% right. So kind [00:53:05] of what you were alluding to. Right. But I’m kind of interested in, you know, for instance, some of the practices you mentioned [00:53:10] to me, you work in Rhona’s practice, you work in Sareen, [00:53:15] which is, uh, the previous London.

Speaker4: Yes, Doctor.

Speaker1: Stafford’s practice.

Speaker3: Now, [00:53:20] Doctor Safir in Knightsbridge. And you work with my friends, uh, Nick and Marjan in the [00:53:25] Wellington Clinic. Also three very sort of different places, all in West London, [00:53:30] like, very different to each other. Um, now, talking about the positives that what you [00:53:35] gain from working in these places, like the nuggets you pick up. Because Romans practice is very [00:53:40] different to any practice I’ve ever been to. She’s very like she’s very unique in herself. [00:53:45] Right?

Speaker4: Yeah.

Speaker3: For the sake of the argument.

Speaker4: Yeah. I mean, there’s only.

Speaker1: One Rona, right? She’s, [00:53:50] uh, you know, she’s she’s she’s, uh. Yeah, exactly. Just a very unique individual. And, uh. [00:53:55]

Speaker3: But it rubs off on the practice, right? The people in the practice, the way everyone is.

Speaker4: Yeah, yeah.

Speaker1: No, absolutely. [00:54:00] And I suppose as far as sort of social media and media, um, involvement, [00:54:05] you know, there’s there’s no better place to be than rhona’s practice. I mean, I’ve been on channel [00:54:10] five, um, you know, off the back of that and on a number of viral TikTok [00:54:15] videos and all the rest of it. And, you know, I’m always I’ve I’ve never naturally been the sort of social media [00:54:20] person, but, you know, I’m always getting dragged in to, like, you know, a room I walk in and they’re like, right, you’re doing a [00:54:25] TikTok video. Sit down, you.

Speaker4: Know.

Speaker1: And and you know what? It’s good because, you know, I [00:54:30] was you know, I’ve always been I’m from a slightly diff. I consider myself [00:54:35] from slightly older generation, from the time where, um, you know, we were taught [00:54:40] to be sort of humble and not talk about your achievements and all the rest of it, whereas social media has [00:54:45] kind of changed everything. It’s the opposite. Like, you know, if you want to be successful, you have to be out there and be [00:54:50] showing off. Essentially, you know, I do this, I’m this, I’m that. And it doesn’t come to me naturally. [00:54:55] But, you know, it’s it’s one of those things where you’ve got to either adapt or you’re going to be left behind, because that’s the way [00:55:00] the world is going now. And um.

Speaker4: But also like.

Speaker3: For instance, in in her practice, there’s lots of hugs [00:55:05] and kisses and even the staff are all like, you know, it’s such a unique place, man. And [00:55:10] it just reflects it’s true about how things come down from the top, don’t they? Yeah, [00:55:15] yeah. Um, I’ve always been interested in, in specialists who go into lots [00:55:20] of practices, you know, because you can really see a lot of different things. Um, and now you’ve got, you’ve you’ve [00:55:25] done your own as well.

Speaker4: Yeah.

Speaker1: So I’ve just, um, I’ve started off my own [00:55:30] sort of endo referral clinic called the London Root Canal Clinic. I’ve got a room in Marylebone [00:55:35] and, um, yeah, we’re starting on with that and trying to build up and see how it goes. [00:55:40]

Speaker3: How many days are you there?

Speaker1: At the moment? I’m there at day and a half a week. Um, so [00:55:45] it’s just building up basically. And, um. Yeah.

Speaker3: Tell me [00:55:50] about how many treatments do you do in a day? You work in a day, work for a day somewhere. How [00:55:55] many how many enders do you do?

Speaker1: The maximum I would do is [00:56:00] five. But that doesn’t happen very often. I would say on average it’s [00:56:05] probably three. And some consults, um, uh, some days might be full, but usually [00:56:10] it’s about three can be two and some consults. Um, so obviously you need to do consults. [00:56:15] I don’t always do consults. Uh, some I ask whoever’s referring to me to send me the X-rays, [00:56:20] and I triage them. So I’ll look at an x ray if it looks like it’s a restorable tooth and it definitely needs [00:56:25] an endo, I’ll say book it straight in for treatment. If it’s, you know, a complex case or questionable, I [00:56:30] think I need to talk about the patient beforehand regarding something. Or if the patient wants to talk about something, [00:56:35] then we’ll go to a consult. So my days will be a mix of somewhere between, let’s say, 2 to 4 enders and [00:56:40] some consults.

Speaker3: And is your fee fixed for treatment and retreatment. [00:56:45]

Speaker4: It’s, it’s more.

Speaker1: Or less the same, give or take, you know, [00:56:50] 100, £200 here and there, but it’s within the same region, more or less across the board. Yeah.

Speaker4: So [00:56:55] I guess it needs to be.

Speaker3: Right because the dentist has quoted the fee already.

Speaker1: Yeah, yeah. No, no, I [00:57:00] mean in every surgery my fee is fixed. Yeah. In every surgery. Yeah. But but but amongst surgeries they’re all [00:57:05] in the same between them. But between the surgeries there’s a slight discrepancy but very slight. So [00:57:10] but yeah, within the surgery my fees are fixed. I’ve got a fee for molar premolar, incisor, [00:57:15] retreatments, usually £100 more. Um. And.

Speaker4: Yeah. Do you mind if.

Speaker3: I [00:57:20] ask how much you charge?

Speaker1: Um, I charge between 1200 [00:57:25] to 1500.

Speaker4: Oh, nice. Yeah.

Speaker3: And [00:57:30] so from a business perspective, yeah, if we’re talking business, you kind [00:57:35] of know how much you’re going to earn, you know, in a year. Kind of right. You [00:57:40] can’t really make a big difference to it.

Speaker1: Um, yeah, I suppose I mean, it depends. You’ve [00:57:45] got the capacity always to work more and do do you know, more work or less? Yeah. [00:57:50] I mean more more, more days, less days, more hours. Yeah, yeah. So, [00:57:55] um, but yeah, I mean, more or less, you know, what you earn within, [00:58:00] you know, give or take certain amount.

Speaker4: Plus or minus.

Speaker3: So then, so then when you’re thinking growth, do you think [00:58:05] are you thinking of endo growth or are you thinking properties or whatever else something outside [00:58:10] of endo.

Speaker1: Um, I.

Speaker4: Think.

Speaker1: Both. I mean, um, I’m thinking, [00:58:15] uh, obviously at the moment I’m doing this whole Endo clinic myself, but yeah, I would [00:58:20] like to, for the future, be involved, definitely in a sort of high [00:58:25] quality specialist referral practice. And I’m not talking just saying, though. I mean, like, uh, you know, high, high.

Speaker4: Quality [00:58:30] disciplinary.

Speaker1: Multidisciplinary practice. Yeah. So, so that’s, that’s that’s something I’d like [00:58:35] to be involved in. Again, I’m probably, uh, I take my time a bit more [00:58:40] than, than other people. People are nowadays just jumping into things. I sort of, you know, take my time [00:58:45] with my things as I go along. So building up and dip my toes in. And that’s the good thing with, [00:58:50] uh, with endo, you know, you don’t have to if I want to start, you know, buy into a practice or start a practice [00:58:55] tomorrow, I don’t have to necessarily leave all my jobs. I can leave, you know, one job, two jobs, three jobs. I can and I [00:59:00] can make as much time available as needed to do what I want to do.

Speaker4: Yeah, yeah.

Speaker3: So [00:59:05] tell me about outside of Endo. [00:59:10]

Speaker1: Outside of Endo.

Speaker4: Yeah.

Speaker3: Outside of work. What do you do.

Speaker4: I don’t have I [00:59:15] don’t have a life. Yeah. No I’m joking. Um, because.

Speaker3: We we do music. We do [00:59:20] music interests. Right. Is it now before it was like actually something you used to do regularly. But is it now like a [00:59:25] hobby?

Speaker1: Yeah. Um, I mean, I like to, I like working out [00:59:30] a lot. Um, I used to do it back in the days for, you know, the way [00:59:35] I look, but now I do it for the way I feel. I think it’s a really, really important part of, um, [00:59:40] you know, both physical and mental health. I try and go to the gym in the mornings most days, [00:59:45] so that’s quite big for me. And in terms of my music DJing, I will do. [00:59:50] You know, I’ve got decks at home. Obviously I can play when I want, I’ve got guitar at home. So, you know, I [00:59:55] play whenever I feel like it. I get invited out to play, uh, to parties. Um, we [01:00:00] just had a kings, uh, indoor party. We can last. [01:00:05]

Speaker4: Kings and Doughnut.

Speaker1: Party or a DJ that.

Speaker4: So that’s [01:00:10] that’s literally it’s.

Speaker1: Literally what I was called the Kings and Doughnut Party. [01:00:15]

Speaker4: That was about.

Speaker3: It’s not quite fabric, is it?

Speaker4: But yeah. No it was. Yeah. It was, it was, it was, it [01:00:20] was.

Speaker1: It was in a hotel with uh. Yeah, I was, it was nice. It was all the sort of past, present, future [01:00:25] professors, students, everyone, alumni all together. So. Yeah, I mean, depends [01:00:30] on what the gig is. Or I get invited sometimes to a West End nightclub because I’ve got friends in the industry, so I play there [01:00:35] as well. Um, you know, I’ve played places as big as Koko in Camden, the O2 [01:00:40] oh two, 3000 people. Yeah, I’ve. I used to play in West End nightclubs all the time. [01:00:45] This is.

Speaker4: Obviously.

Speaker1: This is a bit bit earlier on. Um, I consider [01:00:50] myself semi-retired now on that front, but I used to at one point play professionally. [01:00:55] I used to get paid to play.

Speaker4: So that was.

Speaker3: That was that like, could it have possibly been a [01:01:00] career? Instead?

Speaker1: I was seriously considering it to be at one point. You know, I had I had a manager and I [01:01:05] was, you know, thinking of taking it to the next level. But, um, I decided [01:01:10] not to because, you know, it’s it’s the whole lifestyle of being in that party environment, [01:01:15] which is, you know, it’s not consistent with, um, you know, settling down and, and [01:01:20] future, um, sort of serious life plans, you know, so.

Speaker3: So [01:01:25] the Iranian side took over.

Speaker4: Yeah.

Speaker1: Exactly.

Speaker4: So as, as as.

Speaker1: Much as and [01:01:30] much as I enjoy the actual act of playing a musical performance, whatever it might be with [01:01:35] a guitar or DJing, you know, it’s not it’s not something that I want to do. Seriously. [01:01:40]

Speaker4: Let’s get to.

Speaker3: The darker part of the pod.

Speaker4: Let’s go.

Speaker3: We like to talk about [01:01:45] mistakes, errors.

Speaker4: Um.

Speaker3: Give me, give me, give me some clinical errors. You’ve [01:01:50] made some things we can all learn from.

Speaker1: Okay, so grab [01:01:55] some popcorn and a drink. Yeah. Um, so [01:02:00] let’s start with, um, the first indoor one, which, [01:02:05] um, was as a NHS GDP, and [01:02:10] I was treating a patient who was an exempt patient, um, i.e. for those who [01:02:15] don’t know, doesn’t pay basically for their treatment because, um, you know, they’re covered by [01:02:20] the NHS and it was a low of six. I had a size 25 k-file [01:02:25] in there and it snapped the classic. And um, obviously I [01:02:30] did what I was told to do. You know, all throughout a career, I’d stopped the treatment, took [01:02:35] an x ray, told the patient about it, and patient was unhappy. And [01:02:40] so she basically came back to the practice, made a not formal [01:02:45] complaint, but to the practice, said, you know, he didn’t tell me about this. If [01:02:50] I would have known about this, I would have extracted the tooth. So that’s what she said. [01:02:55] Uh, she it was going to go to a complaint, but luckily I called up [01:03:00] the sort of local NHS community referral unit I spoke to the [01:03:05] head, which was a lovely lady called Caroline Cox, I think her name was. And she was [01:03:10] really, uh, empathetic.

Speaker1: And she explained that she’d had a root canal treatment and someone had broken a file in [01:03:15] her tooth about 20 years ago, and the tooth was still there. Anyway, cut a long story short, she managed to. [01:03:20] She basically bumped up my patient up the waiting list to see the specialist and the dentist who [01:03:25] very kindly treated the tooth, got the file out and finished the case for me. So I got out of that one. But the lesson [01:03:30] that that taught me straight away after that case, I when I wrote up a consent form, I [01:03:35] wrote up a consent form with everything that I could possibly think can go wrong in an endo [01:03:40] case. And every patient that I’ve done endo from endo on since [01:03:45] then, I always give a written consent form because that, you know, the fact that she said, [01:03:50] you know, you didn’t tell me that this could happen beforehand, and if you did, I would have extracted a tooth, which I think was a bit extreme. [01:03:55] But, you know, she was going to go on that and just, you know, take it further basically. But that, that nipped it [01:04:00] in the bud.

Speaker3: Fortunately at this point you weren’t an endodontist, right?

Speaker4: No, this.

Speaker1: I was [01:04:05] early, early on in my GDP career. And, you know, this was one of the things that put me off. And though, you know, you know, you [01:04:10] finish university and you go into practice. I was in an NHS practice. I was using K files to prepare my canals. [01:04:15] Right. And you know, you’re getting paid three udas for it, which was £30 back then. And [01:04:20] you’re thinking, you know, you want to do your best for the patients, but, you know, you barely, you know, I didn’t have an apex locator. [01:04:25] Imagine. And you know, you’re doing working like that and spending all your time [01:04:30] getting paid barely anything. You’re nervous at the end of it because the case didn’t go that well. And it’s [01:04:35] like, you know, why? Why am I doing this?

Speaker3: So but give me, give me, give me an endodontist [01:04:40] failure like an endodontist error.

Speaker1: So I’ll give you another one. I’ve got loads, [01:04:45] I’ve got loads.

Speaker4: Um, so, uh.

Speaker1: I learned the hard way. [01:04:50] Um, so this one is more about, [01:04:55] uh. Well, yeah, it’s, it’s an error and it’s about communication. So this is probably, uh, it [01:05:00] was the first year after I qualified as a specialist, and I was a clinical teacher already at King’s. Um, [01:05:05] I had a patient who was 15 year old girl, came in with a dad. She had a lower incisor, [01:05:10] which was already root treated reasonably well. History of trauma. And it had a [01:05:15] pretty big, big infection around it. So I looked at this tooth, I did [01:05:20] the assessment and I said, okay, look, we can we can treat this. For [01:05:25] some reason. I didn’t mention surgery. And the reason I didn’t [01:05:30] mention surgery was in my head. I was like, this girl is 15. [01:05:35] I don’t want to scare her. Let me be the nice guy. And me didn’t mention it right? Even though [01:05:40] my ethos and this is I always teach my students as well, is when it comes [01:05:45] to endo. Always, always, always undersell and overdeliver. So every patient I [01:05:50] see, I always prepare them for the worst outcome, which is a tooth extraction basically. So that [01:05:55] way it does two. Number one I think is a part of consent anyway, because any tooth which is due [01:06:00] for an endo could potentially end up being extracted.

Speaker1: And number two, once you’ve had [01:06:05] that conversation in a really nice way not to put the patient off, but it puts you at ease. [01:06:10] And that’s the most important thing. If you if you start treating the case and you’re already anxious or apprehensive, [01:06:15] that’s not going to go well anyway. Long story short, this patient comes in for a treatment. I go [01:06:20] in, remove the GP. There’s two canals. Lower incisors quite often have two canals. And, [01:06:25] um, there was a little isthmus. So like a little small area connecting the two canals. So I was like, [01:06:30] let me, you know, there was some GP stuck in there which I wanted to get out. So I put ultrasonic tip in there. [01:06:35] And in this practice, which I was working at, they didn’t have the ultrasonic unit that I [01:06:40] would ask for. So it was like a sort of, let’s say, budget one, which didn’t have, you know, the [01:06:45] sort of very, very, uh, so graduations, which you can start, you know, with low power. And it [01:06:50] was quite high powered, basically. I. Put ultrasonic tip in that put my foot down and snapped the [01:06:55] ultrasonic tip snaps in the isthmus. So I’m.

Speaker4: Like.

Speaker1: Yeah, so I’m okay. I’m like, it’s fine. [01:07:00] You know? I’m an endodontist. I can deal with this. So I turned the power right [01:07:05] down on the device, go back in to try and sort of vibrate that little tip and take it out. Another [01:07:10] piece of the ultrasonic tip breaks.

Speaker4: Oh my goodness. And now that piece is.

Speaker1: Goes [01:07:15] right down to the end of the root.

Speaker4: Well, now.

Speaker1: In this practice that I worked at, um, the microscope [01:07:20] wasn’t the best microscope. So I’m looking in there already. I’m like, you know, that sinking feeling, [01:07:25] your heart sinks. You’re like, damn. Like what? How am I going to break this to, you know, to [01:07:30] to the. And the dad was saying that, you know, he had sort of, you know, one of these parents who was, [01:07:35] uh, you know, really sort of on everything, and, you know, daddy’s girl, you know, I wanted to make sure daddy’s girl is going to be [01:07:40] fine. So, you know, take a few deep breaths, try and calm down. Uh, anyway, temporise [01:07:45] the case, I’m like, look, um, so. And whenever I explain errors to patients, I [01:07:50] think it’s really important to not sound nervous. So I make sure I sound calm. I’m like, look, [01:07:55] basically this has happened. It’s, you know, one of the common procedural errors in endo. Don’t worry about it. [01:08:00] You know, um, the microscope in this surgery is a isn’t the highest powered one. I’m going to take [01:08:05] you somewhere else to sort it out with a higher powered microscope. Kyle, long story short, take him to [01:08:10] another surgery. Try my hardest. I can’t get them out. So he’s got two fractured [01:08:15] ultrasonic tips at the root end of this 15 year old girl.

Speaker3: So [01:08:20] what happens next?

Speaker4: So then I was like, damn.

Speaker1: I was like, um, [01:08:25] this is this is not going to go well, fortunately, um, one of the perks of being [01:08:30] a clinical teacher at guy’s is you’ve got that insurance policy there available to you. [01:08:35] So I basically said, look, um, this case is going to need [01:08:40] a surgery, which the lesson I learned if I had not been, you know, in [01:08:45] my head, being the nice guy and trying not to scare the girl, I should have mentioned from the beginning, because the [01:08:50] tooth with that big lesion, any tooth which has got a lesion that size, you always have to mention apical surgery as [01:08:55] one of the options. And had I mention that I wouldn’t have had that stress and sleepless night anyway. So [01:09:00] anyway, long story short, I took the guy’s. But I was so nervous about that point, about that case at that point myself, which I didn’t [01:09:05] want to do it. So I kind of. And so I kind of gave it to one of my, um, colleagues, uh, Federico [01:09:10] Foschi, who’s a consultant there who very kindly did the surgery for me. And that was that healed beautifully. [01:09:15] And everything went well. But I honestly had I can’t remember a case [01:09:20] for a long time before and after or since, um, that, that I’ve, you know, [01:09:25] had sleepless nights other than that, because I was thinking, damn, like, you know, this, you know what [01:09:30] if what if, you know, this tooth has to go? What if this, what if that? And you know, the fact that I hadn’t mentioned [01:09:35] the surgery. I mean, they took it quite well. I was lucky it could have gone a lot worse than it did. Uh, to be fair. [01:09:40] But the point, again, is to don’t let your niceness get [01:09:45] in the way of explaining things that can go wrong to your patient. So make sure you communicate all [01:09:50] the risks before you begin.

Speaker3: On that point of, uh, you know, finding [01:09:55] someone to help you. Just how often does that happen? How often? [01:10:00] How often do you refer to an endodontist? Very, very, very rarely.

Speaker1: Not so. [01:10:05] So let me tell you something. I would say that since becoming a clinical [01:10:10] teacher, my skills have advanced by far more [01:10:15] than during my entire specialist training. By magnitude of, I don’t know, [01:10:20] five. Why? Why? Because when you’re teaching [01:10:25] in the post-grad department, number one, you’re treating some of the most complex cases which you wouldn’t treat in practice. [01:10:30] Because in practice, let’s let’s face it, when the patient comes and the tooth is beyond a certain point, the conversation [01:10:35] is, am I going to pay 1000 1500 to do an endo, plus a thousand for [01:10:40] a crown, or am I going to go for an implant? So there’s certain cases you just don’t do that you do in hospital. That’s number one. Number [01:10:45] two, you are the guy that gets called over when things go wrong. So you get [01:10:50] good at fixing problems, you know, oh, the canal is alleged. Can you bypass the ledge? The instrument broke. Can you take it [01:10:55] out? I perforated, can you fix it so you’re constantly fixing problems? So after having done that now [01:11:00] for about four and a half years, I feel like, you know, again, well, I still learn, you know, we’re [01:11:05] still, you know, we discuss cases. I’m always learning. I’m not definitely not the finished article. I don’t think I ever will be, [01:11:10] but I’m at a point where I would say it’s very rare for me to need [01:11:15] to ask help. You know, there will be the cases where, you know, diagnostically, you know, we’re [01:11:20] scratching our heads.

Speaker1: You know, we’re trying to think what’s to do best with, you know, what’s the best thing to do for a patient? [01:11:25] Again, another case we did very interestingly, which is something I wouldn’t do in practice, [01:11:30] but I had a very complicated case. It was a lower for an Afro-Caribbean lady. Sometimes [01:11:35] the canals and lower premolars trifurcate. So they split into three canals, so filled [01:11:40] one of the canals, the other two were completely calcified. So, long story short, didn’t work and the [01:11:45] root end was very close to the mental foramen. So surgery that was very risky. So [01:11:50] we took it to guys like what should we do? And we decided to do intentional replantation. Have you heard of that? [01:11:55] So basically what we did, we extract the tooth, we do the surgery [01:12:00] out of the mouth and we put it back into wow. Yeah. So, so and and you [01:12:05] know that there’s a lot of specialists who are doing that now and who are quite good. Well not a lot. There’s let [01:12:10] me rephrase. There’s a few specialists, very few specialists who do that in practice [01:12:15] around the world to do conferences and get good success rates, but it’s definitely not something that [01:12:20] most specialists do. But again, being in guy’s, I got to do that treatment because [01:12:25] it was guys. And you know, you take cases there which you just wouldn’t attempt in practice. [01:12:30] And it’s these kind of things which you do there which which make being clinical teacher just [01:12:35] completely invaluable.

Speaker4: So in in.

Speaker3: The world of endo, is there other like you [01:12:40] said, there’s a guy who’s, who’s sort of subspecialty is this who goes around the world teaching [01:12:45] this. What are the other subspecialties? Are there some some guys who are like a discectomy guy’s [01:12:50] only like, what are they?

Speaker4: Yeah. So I mean.

Speaker1: We had, um, I’m part of this [01:12:55] endo geek group called the Langham, which we have three meetings a year and we get, like an international speaker [01:13:00] and they come and deep dive a whole day on, like, a certain thing. So. So we had this guy who’s, [01:13:05] um, basically he does this technique called the lit technique or the window technique, [01:13:10] um, where he is for apical surgery in the mandible mainly. I mean, you could do it anywhere, [01:13:15] but for example, in the mandible where you’ve got that thick cortical bone, um, instead of just trusting [01:13:20] a hole in the bone to try and get to the root, you use piezoelectrics and, [01:13:25] uh, ultrasonics basically to cut a window and basically remove that window of [01:13:30] beau, expose the root, do the surgery, and then put that lid back on.

Speaker4: Oh, yeah. [01:13:35]

Speaker1: So, so there’s a guy who basically in America who just just does, you [01:13:40] know, he’s like a I mean, he does everything obviously. But that’s like his niche. So we’ve got that. We’ve got [01:13:45] guys who do intentional replantation. We’ve got guys who do autotransplantation conferences. So, you know, they’ll take a tooth [01:13:50] out from somewhere else and put it another, another, uh, another place in the jaw. Trauma. Guys, [01:13:55] uh, trauma is a big part of vendor.

Speaker3: What about compared to other countries, [01:14:00] how are we in the UK? And was that where is the top endodontist [01:14:05] country? Is it America?

Speaker1: I would say definitely UK. [01:14:10] Us are at the top.

Speaker4: Really?

Speaker1: Yeah UK, US, [01:14:15] Sweden like you know but the European countries definitely by far more so [01:14:20] than um, I would say the Arabic countries because I know, [01:14:25] you know, I did quite a bit of research. I was interested in Dubai for a while, so I went and had a look out there and [01:14:30] sort of standardisation. You know, we’ve got not a lot of places in the world to have, [01:14:35] uh, specialist register, for example, we do in the UK and the US and to get on the specialist [01:14:40] register is incredibly difficult. So give me an idea. Um, the last time I checked, [01:14:45] there’s approximately 43,000 registered dentists in [01:14:50] the UK, and there’s about 320 registered endodontists.

Speaker4: So that is.

Speaker1: Yeah, [01:14:55] so so.

Speaker4: So so so.

Speaker1: Obviously to get on that list is hard work and you know [01:15:00] it. You know, some someone who’s on that list, you can expect a reasonable level of, [01:15:05] you know, reasonable level of quality of treatment from them, which you, I suppose, don’t have in a lot of other countries. [01:15:10] Um, again, I’m not saying there’s not amazing people everywhere.

Speaker4: But it’s.

Speaker3: Interesting you say that because I don’t think there’s [01:15:15] any other part of dentistry where I would say the UK is leading.

Speaker4: Maybe.

Speaker3: Maybe, [01:15:20] maybe, maybe, maybe the ABC area because of Tiff.

Speaker4: Because of.

Speaker3: Tiff [01:15:25] Qureshi. Yeah, but but although I think, I think standards are getting better but you know [01:15:30] like when you, when you go to international conferences and you see some of the stuff people are doing from [01:15:35] abroad.

Speaker4: No, the end of the endo.

Speaker1: Unit especially are under unit at King’s and especially [01:15:40] in terms of research output as well. It’s excellent. It’s world leading. It’s world leading. Yeah. Yeah. [01:15:45]

Speaker3: So all right then let’s talk about [01:15:50] if you are working as an endodontist. In the early [01:15:55] days. And you’re trying to you’re trying to get referrals. I mean, how did you manage to be [01:16:00] this guy who’s who’s in all of these top practices or, or is it because there’s so few endodontists it’s not [01:16:05] such a hard thing to do?

Speaker1: Um, I think first of all, endodontists [01:16:10] are highly in demand at the moment.

Speaker4: Yeah. Is that the reason? So. [01:16:15]

Speaker1: So, um, partly, but I mean, I was I always wanted to be the guy who [01:16:20] works. I mean, I’m lazy. I wanted to keep my commute time minimal. And I live in central London.

Speaker4: So.

Speaker1: So [01:16:25] I wanted to work. I wanted to work as close as possible.

Speaker3: Um, but, you know, from that, from the marketing side [01:16:30] of it, from, you know, you have to market yourself to high end dentists, right? [01:16:35]

Speaker4: Yeah.

Speaker3: So, so that skill is that is that something you have to work out all the time. [01:16:40]

Speaker1: I suppose. I mean, I’m quite, you know, I’m good with people. [01:16:45] I used to work I used to work in the sort of, uh, entertainment or nightlife [01:16:50] industry. I used to, I used to do event organisation. You know, we have to go out and schmooze people to come to our events. [01:16:55] So, you know, I’m I’m generally good with, um, you know, uh, talk talking to [01:17:00] people and building rapport. So I guess it starts from there and then, you know, and [01:17:05] when it comes to work, you know, I’ve built a reputation by working in places. And people [01:17:10] talk, obviously, and they know it’s not just about the quality of work, but also the [01:17:15] way I treat patients. You know, I treat patients always, you know, with a lot of care. [01:17:20] I’m very meticulous in what I do. Again, in terms of managing anxious patients. [01:17:25] I as I said early on in my career, I used to work in a sedation referral practice, [01:17:30] and one of my things that I pride myself on is throughout the years, I’ve managed to [01:17:35] wean a lot of people off sedation. So I think dealing with anxious patients is [01:17:40] another sort of strength of mine, which is which is attracted people to me, really. [01:17:45] And a lot of these places, a lot of these jobs that I’ve got, they’ve, you know, they’ve they’ve heard about me and they’ve sort of approached me [01:17:50] and said, you know, we’d really like you to work in our practice. So that’s that’s how I ended up in most of [01:17:55] the places that I did. Um, it started with one, actually. My first, my first [01:18:00] central London endo job was actually at the Chelsea Dental Clinic before Rona bought it. [01:18:05] So that’s that’s where I started out. And I suppose Ron Rona’s had a hand in, [01:18:10] um, in, in promoting me as well because, um, obviously she’s very well known. And then I [01:18:15] became Chelsea Dental Clinics, Endodontist and then everyone else, uh, you know, became interested as well. [01:18:20] Mm.

Speaker3: Yeah. Lovely family. Used to own it before. Um, yeah.

Speaker4: Joseph. Joseph. [01:18:25]

Speaker3: Joseph. Joseph. Yeah, yeah. Lovely people.

Speaker4: Yeah.

Speaker3: Um, but but then, you know, [01:18:30] as a specialist, generally you’re having to do this a lot, right. So did you do study clubs [01:18:35] and. In. Do any of the practices organise stuff like that?

Speaker1: Um, [01:18:40] some do, but it’s not. It’s not mainly study clubs. I mean, they’ll, they’ll, you know, there’ll be odd sort of CPD [01:18:45] event where I speak at here and there. Um, but obviously we’ve got our own [01:18:50] sort of endodontist, um, geek clubs. Like I said, I’m part of the committee of this thing called the Langham [01:18:55] Study Group. And also, obviously, I’m a clinical lecturer at, uh, at [01:19:00] King’s. So, you know, I’m there once a week mixing with some of the, you know, world [01:19:05] leaders in research. And, um, you know, I’m getting to talk to [01:19:10] them about cases, and you keep you keep up to date in that way. So that’s it’s [01:19:15] a really good thing to do. Uh, it’s a thing I do one day a week. And, [01:19:20] you know, it’s definitely not something you do for the money.

Speaker3: Yeah. You’re taking a massive pay pay drop. Yeah. [01:19:25]

Speaker4: Massive massive.

Speaker1: Massive. Yeah.

Speaker3: So do you enjoy teaching?

Speaker1: I do, I do [01:19:30] a lot. Yeah I think I think.

Speaker4: I.

Speaker1: You know, you actually learn [01:19:35] a lot by teaching. And it’s also lovely to be able to sort of pass it down, pass your knowledge [01:19:40] down. So I teach I teach undergraduates as well, uh, not just postgraduates. And I started [01:19:45] teaching the reason I got the joke, but one of the reasons I got the job is I when I was a post grad, I used to teach undergrads, [01:19:50] and I used to be, you know, quite keen on it. And, you know, as soon as I qualified, they gave me a job there straight away. [01:19:55] And, um, I think it’s nice to be able to impart that knowledge, um, [01:20:00] down to, down to new generation, teach them, you know, it’s like it’s like a [01:20:05] baton that we pass along. And again, it’s good for your own learning. Like, you know, I [01:20:10] think it was Einstein or someone who said that if you really understand something, if you can explain it to a six [01:20:15] year old. So, so, so, you know, you we all get in this sort of way of [01:20:20] doing things, but we don’t actually think about why we do what we do. So then when you actually have to break it down [01:20:25] and explain it to someone else, it really makes you understand things better. And, you know, sometimes you actually [01:20:30] be like, why am I doing this? And, you know, you go back and read and look things up. And so, yeah, it just [01:20:35] elevates your own, uh, you elevates yourself as a clinician.

Speaker3: And there’s the odd [01:20:40] endodontist who has like a brand and then there’s endodontist working [01:20:45] for them.

Speaker4: Yeah.

Speaker3: Is that a thing you might do.

Speaker1: Oh, as in [01:20:50] build the clinics and then have another endodontist working.

Speaker3: Yeah. I mean, I’m thinking of an spandaryan. [01:20:55]

Speaker4: Yeah. Yeah. No, absolutely.

Speaker1: I mean that’s, that’s that’s definitely a goal as well. Obviously [01:21:00] if you can, the goal is to start a referral practice and then get it to a level where then you know, you can [01:21:05] have other endodontists working there as well. That’s uh.

Speaker3: Is that is that quite a common thing?

Speaker1: I [01:21:10] wouldn’t say it’s common, but there’s a, there’s a few of them and I suppose it’s going to overall [01:21:15] get less common as this sort of, you know, especially in London the most mostly. [01:21:20] And, and London is saturated with, um, with endodontist compared to other places. So and [01:21:25] there’s a big surge in private and squat practices and everyone wants to have [01:21:30] their own endodontist. So, you know, there’s going to be less people referring out going forward, [01:21:35] I think.

Speaker3: Amazing, man. What an insight. Who would you say is the world’s [01:21:40] top endodontist?

Speaker4: Uh.

Speaker1: That’s a that’s a difficult one.

Speaker4: But [01:21:45] a few of.

Speaker3: Them, a few of them.

Speaker4: I.

Speaker1: Would definitely say I think it’s agreed amongst [01:21:50] the endodontist when it comes to clinical skills. There’s a Italian gentleman [01:21:55] called Massimo Gervasio who is, uh, also [01:22:00] used to teach at King’s. He’s based in Bristol. He runs a training academy called Delta Dental [01:22:05] Academy.

Speaker3: Oh, I know, no more. Massive. Yeah, yeah. Sorry, sorry. Yeah.

Speaker4: With Prav Prav. [01:22:10]

Speaker1: Uh, his.

Speaker4: Website as well. So. So, uh, he’s.

Speaker1: He’s known amongst the [01:22:15] endodontists as being, you know, the, you know, one of the, if not the best when it comes to skills. [01:22:20] He is he is really, really excellent, I would say.

Speaker3: But what does he do? What do you mean? [01:22:25] Skills. The kind of canals he can.

Speaker4: What.

Speaker1: Uh, like if [01:22:30] you, if you look at his work, it’s like artwork, like everything he does. Really everything. It’s not just the canals. He does [01:22:35] restorative work as well. Like every. Everything he does is just perfect. Basically. That’s that’s [01:22:40] the way I can describe it. He’s a perfectionist more than, you know, amongst endodontist or perfectionist [01:22:45] anyway, but he’s a perfectionist amongst the perfectionist. So you can imagine the level. And [01:22:50] um, you know, he does things like 3D prints teeth beforehand. Like if he’s got a complex case, he’ll [01:22:55] 3D print the tooth and plan the treatment beforehand and all sorts.

Speaker4: Of these.

Speaker1: These [01:23:00] sort of advanced things. And the way he, he trains as well [01:23:05] is quite good because he’s got he brings, uh, people over and he does live [01:23:10] patient treatment, both sort of supervising them and also him doing it and sort of showing what he’s doing [01:23:15] on a big TV so people can actually watch live and actually take part and treat live as well. I mean, you’ve [01:23:20] got a lot of that going on for, um, implant dentistry at the moment, but not really, um, for [01:23:25] um, for endo as much. So that’s kind of unique in what he does as well. But [01:23:30] his academy is based in Bristol at the moment.

Speaker3: Yeah, yeah. With, with with um my. [01:23:35]

Speaker4: The its.

Speaker3: And [01:23:40] its it can take care of this one.

Speaker4: Alfonso. [01:23:45]

Speaker3: With my body. With my buddy Alfonso.

Speaker4: Alfonso? Yes. With Alfonso. Yeah.

Speaker3: Um. [01:23:50] All right. We’ve [01:23:55] come to the end of the to our time at the end of our time. Um, let’s [01:24:00] get on to the final questions. Fancy dinner party. Three [01:24:05] guests, dead or alive. Who’d you reckon?

Speaker4: Hmm. [01:24:10]

Speaker1: So the first guest would be someone who I’m not actually sure [01:24:15] existed or not. Might be mythical, but it’s going to be Adam.

Speaker3: Of Adam and Eve.

Speaker4: Yep. [01:24:20] What a great.

Speaker1: Uh, I want to see [01:24:25] if it was actually the first and only man. I want to see what the Garden of Eden was like. [01:24:30] And I wanted to see if Eve and that poison apple were worth getting kicked [01:24:35] out of the Garden of Eden.

Speaker3: Do you believe in God?

Speaker1: I believe [01:24:40] in God as an intelligent creator. And that’s a [01:24:45] debate. Um, which favourite author of mine? More God that, uh, went through [01:24:50] deep dive into and is like, uh, sulphur, sulphur happy and [01:24:55] um, and yeah, um, I think on the balance of probabilities, there is an intelligent creator [01:25:00] and therefore I believe in God. Yeah.

Speaker3: I like Mo, I think, I think I think Rona knows him. [01:25:05] I’m he’s my dream guest. I want I want to have him on.

Speaker4: Well, [01:25:10] well, he’s he’s he’s.

Speaker1: One of mine. So he was he was going to be my third guest.

Speaker3: Oh [01:25:15] amazing.

Speaker4: So he’s the second guess.

Speaker1: Uh, the second [01:25:20] guest would be, I think I want to say someone [01:25:25] from the Illuminati, but I’m thinking. I’m thinking someone like Larry Fink, [01:25:30] like a CEO of Blackrock.

Speaker4: Or someone else.

Speaker3: Someone, right?

Speaker4: Yeah. [01:25:35] Someone. Someone. Someone who knows.

Speaker1: What happens behind the closed door meetings in Davos and all that. [01:25:40] Like just get a little insight into what’s really happening.

Speaker4: Yeah.

Speaker3: The proper Iranian conspiracy [01:25:45] theorist. Right. So when I was on another podcast and the question was something [01:25:50] like, uh, where would you like to be a fly on the wall? And I was like, wherever, you know, like [01:25:55] gave the order to shoot Kennedy, you know, like that, that that moment, you know. Yeah.

Speaker4: Exactly. [01:26:00]

Speaker1: Exactly something like.

Speaker4: That.

Speaker1: And and. Yeah. My God, that’s obviously [01:26:05] he’s I think he’s an amazing mind and, you know, just just has so much to, you [01:26:10] know, so much to learn from him really. But both in terms of, you know, his journey with, um, you [01:26:15] know, with tragedy in his life and his and his and how he got over that. And also, he knows [01:26:20] a lot about AI, and I think we all need to.

Speaker4: Learn.

Speaker1: A bit more about that because it’s coming [01:26:25] to get us.

Speaker4: Yeah. Do you listen to his podcast?

Speaker1: I do, yeah, I listen to some of it, yeah. And [01:26:30] yeah. And it’s also and he’s also a great narrator [01:26:35] as well.

Speaker3: Amazing, amazing. Good choice. Good choices man. Yeah. Good choices. All [01:26:40] right. And Travis, final question. It’s a deathbed question on your deathbed, [01:26:45] surrounded by your loved ones. By that time. Old children. Three [01:26:50] pieces of advice you’d leave for them and for the world.

Speaker1: I [01:26:55] think the first one I mean, I’ve got I’ve got a lot, but I think the first one would [01:27:00] be to love yourself. And what I mean by that is not in a narcissistic sense, because [01:27:05] people are narcissists actually portray an image of self-love, but they actually [01:27:10] it comes from an element of insecurity and something that they don’t like about themselves. Self. [01:27:15] To really love yourself means to accept yourself for [01:27:20] everything, good and bad that you are. And I think if once someone loves themselves truly, [01:27:25] then they’re really capable of loving, you know, everyone else. And that will solve a lot of problems in the world [01:27:30] if people really love themselves and accept them themselves.

Speaker4: It’s interesting.

Speaker1: And [01:27:35] yeah, so I think that’s one. And the second one would be to [01:27:40] treat others as you’d like to be treated yourself. I think that’s always been a guiding [01:27:45] principle of mine. And finally to and [01:27:50] this is something again, I aspire to, which is why I would advise it. It’s to think [01:27:55] less and act more. Probably wouldn’t apply to everyone. Uh, but [01:28:00] yeah, especially someone like myself.

Speaker3: It’s interesting because the question could [01:28:05] be, it could be this is what I did and it worked, or it could be this is what I didn’t do, but I wish I did. [01:28:10] And that’s what you’re saying.

Speaker1: The other answer I was going to give, and this is going to go back to our [01:28:15] Iranian roots, is good thoughts, good deeds, good actions, sorry, good thoughts, good thoughts, [01:28:20] good deeds, good words.

Speaker4: Let’s say let’s let’s say that again.

Speaker1: It’s going to be good [01:28:25] thoughts. Good deeds, good actions.

Speaker4: Goes back to the old Zoroastrian [01:28:30] festivals. Yeah.

Speaker3: That is beautiful. That is beautiful. Tell me about the first one though. Um. [01:28:35] Love yourself. Are you saying your weaknesses? Love your weaknesses? Acknowledge them.

Speaker1: So [01:28:40] a lot of self-love comes down to accepting yourself for who [01:28:45] you are. And, you know, there’s there’s a book I read in the Realm of Hungry Ghosts by Gabor [01:28:50] Mate, and he’s an expert in trauma, and he believes that all [01:28:55] addictions and we’re all addicted to something, by the way. And he believes that [01:29:00] all comes from trauma. So, you know, there’s some sort of trauma. That trauma starts a sequence of self-loathing, [01:29:05] which then leads us to this behaviour of addiction. Um, and [01:29:10] that’s only one aspect of it. Um, the other parts come to sort of things like aggression and [01:29:15] harming other people. And, you know, they always say the person who’s been abused becomes the abuser, right? [01:29:20] So and the reason they do that is because they’ve got this part of themselves which they [01:29:25] dislike, and then they bring that out and portray that and act on it onto other people. [01:29:30] So if you really learn to love yourself and accept yourself for who you are, no matter, [01:29:35] you know, we’ve all got things which you don’t like about ourselves or like less or like more. Just accept yourself. Love yourself [01:29:40] for who you are and what you are, and then you will be able to, you know, love other [01:29:45] people. That’s the side effect of loving yourself truly and accepting yourself.

Speaker4: Um.

Speaker3: And [01:29:50] your third one about jumping in. Are you saying you’re overcautious?

Speaker4: No. [01:29:55]

Speaker1: I spend a lot of time thinking, um, about things and, you know, and thinking, [01:30:00] you know, I used to think it’s a good thing, you know, I’m into sort of reading and philosophy and [01:30:05] all this, and and I think it’s good to some extent, but, you know, that I can say [01:30:10] is, you know, maybe one of my addictive behaviours is just, you know, get deep diving into things [01:30:15] and learning about, you know, things which aren’t really beneficial to my life necessarily and [01:30:20] thinking about them. And I spend a lot of time in my head. And life in your head isn’t living. Living [01:30:25] is action. So. So, you know, if I could give myself some advice, which I’m trying to [01:30:30] take is to, you know, think less and just act more, do things, you know, if you want to start a business or do [01:30:35] whatever, just, you know, make do the actions and just get up and do it instead of thinking too much.

Speaker4: You know, I think.

Speaker3: I [01:30:40] don’t know, it’s a related thing. I don’t know if you’ve heard that they say people are either foxes or hedgehogs [01:30:45] and and I don’t know, foxes. Think about all the different permutations [01:30:50] and all the different possibilities of things that could happen. I’m like that too. [01:30:55] And then hedgehogs are very simple, clear. If this happens, do this. If that happens, do that. And it turns out [01:31:00] hedgehogs are much more successful than foxes, even though they might not be as [01:31:05] deep or whatever, you know, like whatever it is.

Speaker4: Yeah, yeah, yeah, exactly, exactly.

Speaker1: It’s exactly.

Speaker4: That. [01:31:10] Yeah.

Speaker3: It’s been a lovely conversation. I really enjoyed it. Really, really enjoyed it. Really nice. Like, [01:31:15] you went quickly um, and, uh, and, and the end is a wonderful [01:31:20] thing, man. You know, I wish more people considered endo, but I think we’ve all had [01:31:25] a trauma early on. That puts us off. And you always. [01:31:30] You endodontists prey on that.

Speaker4: That’s [01:31:35] true. That’s that’s very true. Yeah.

Speaker1: We don’t need.

Speaker4: To speak to and, uh, and and [01:31:40] see.

Speaker1: If we can convince more and more dentists to go down the.

Speaker4: End of the path and get.

Speaker1: Over their [01:31:45] traumas.

Speaker3: But thank you so much for doing this, buddy. I really enjoyed that.

Speaker1: It’s an absolute pleasure. [01:31:50] Thank you for your time. Thanks for having me.

Speaker2: This is Dental [01:31:55] Leaders, the podcast where you get to go one on one with emerging [01:32:00] leaders in dentistry. Your hosts. [01:32:05] Payman Langroudi and Prav Solanki.

Speaker5: Thanks for listening, [01:32:10] guys. If you got this far, you must have listened to the whole thing. And just a huge thank [01:32:15] you both from me and pay for actually sticking through and listening to what we’ve had to say and what [01:32:20] our guest has had to say, because I’m assuming you got some value out of it.

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