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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