The transcription is from a podcast interview with orthodontist Zayed Esmail. He emphasizes that the foundation of successful orthodontics is excellent communication and building trust, especially during the initial consultation, by being transparent about achievable outcomes. He highlights the unique, close relationships formed with patients due to frequent appointments over years, which is personally fulfilling though sometimes bittersweet when treatment ends. The discussion covers his practice within a Bupa framework, where he maintains a distinct brand identity. A significant portion focuses on the ethical dynamics between NHS and private care; he prefers a model where he can present all options without financial pressure to "sell" treatment, ensuring he can practice ethically. He notes orthodontics often improves patients' overall dental hygiene and self-esteem. While acknowledging private orthodontics, especially for children, can be a strong business driven by parental concern for aesthetics, he is motivated more by treating complex cases and achieving good results than by commercial factors alone. The conversation concludes with his personal background and path into dentistry and orthodontics.
One of the most common questions I get is how do I do more teeth whitening? The basis of that is to really believe in it and the basis of that is to fully understand it. Join us for enlightenment online training on enlightenment online training.com to understand how to assess a case quickly, how to deliver brilliant results every time, next time whitening underwhelms, try and lighten. Now let's get to the pod. This is dental leaders. The podcast where you get to go one on one with emerging leaders in Dentist Street. Your hosts, Payman Langroudi and Craft Salon King. It gives me great pleasure to welcome Zayed Esmail onto the podcast side, a specialist author, a dentist who works in a Booper practice and also teaches a lot with your online authentic academy, which is interesting. I think there's a real need for that these days, Zayed. Good to have you, buddy. Thank you. I'm glad to be part of this. Well done for coming all the way to the office. I want to start with a very general question, but hopefully you'll like it. What's the difference between a good author dentist and a great author dentist? I think a couple of things, I think communication, I think any clinician really communication is massive. I find it with my patients that they, apart from the ones they get referred through word of mouth, the ones that come through, they don't know what to expect, they don't know you, are they going to trust you in the next two years to do the treatment, are they going to trust you, the money they're going to pay you? It's not like a general dentist, we see them every six months and you kind of get to know them, they either be referred in or they found you online. So I think communication is key and I think that initial appointment is key and I think being honest with them about what you can achieve and what you can't achieve, I think is massive. And I think the more I've been doing it, the more sometimes when I almost not put off a patient but go through all the risks from from day one, that they realise actually you're not trying to pull the wool over their eyes and the more you do that, the more they trust you. And I think it's really important to be personable and because you're going to see these patients every six, eight weeks, essentially these patients become your friends, you know, you're going to see them maybe every 18 months, you have that, relationships they may not have with their general dentist because they're seeing germs every six months but we're seeing them every six, eight weeks, we see the parents every six, eight weeks and we really get to know them, which is the great part of the job, but I think it's also the the bad part because after that two years, after that retainer review, after we've stopped seeing them, we don't necessarily see them again unless there's a problem. So sometimes I'll, the older sibling that I've treated comes back with the youngest sibling and then you see them and then you've, you know, you've seen how much they've grown and changed and so it's one thing that you kind of have a really close knit relationship with them for the two years and then and after that you don't see them again, which is, which is sad, but it's but it's lovely at the same time, it feels like I'm staying the same age because all my patients are roughly the same age, so I feel like I'm almost treating between 11 and 14 year olds until when they come back as an older sibling seven years later and you think, oh God, I've been doing this for a, for a while. So that I really like and then you end up treating siblings, you end up treating parents and you end up treating the whole family and that is, that is great, but I think that really comes down to doing, I think it's quite simple, just do a good job and just be nice to people and nice people hang out with other nice people and because we see patients are, our patients are six, eight weeks, I'm always very good at leaving a little note on when you have a conversation about what we think half-term and it's over going to France and they come back in six weeks later, how is France and oh good memory. So that kind of, there's little tidbits that I've picked up along the way and just because they see you almost as a friend, I think you've almost have to see them as a friend as well. So for every, every patient that I start, like either put bond upon, bond the braces on or fit their attachments a week later, I call them. So my Thursday evening before I go home, I call the patients from the previous week, the ones I put, resident check, they're going okay and it's the same conversation every time, you know, and they're so appreciative about it and it's such a simple thing, it takes two minutes out of my time, but I don't see it as a tool and I don't delegate it to other staff because I think I want it's nice that they hear it from me and actually I've, Jenny, want to know that just make sure they're okay because if they are, then I can sleep, I can join my weekend, I don't work for it. This is my Thursday night, I get all my admin done, get it all done, I can enjoy the weekend, I can enjoy the weekend, I can know in the patients that I've treated are in good hands and happy. So I'm very lucky to be in this field. Are you treating mostly adults or kids? I say mostly kids because our practice has a quite a large NHS contract, so the private that comes from there are patients that don't qualify or they want alternative options with the NHS, doesn't fund. And I'll say the majority of my adults that I treat are probably parents of kids that I've treated. So we're a bit of a niche practice within Bupa because we've kept the original branding of the practice. So we've grown a house with on to practice because when Bupa bought out total, they changed all their practice to total but there's a total practice up the road. So we can really, really rebrand to total so we don't really have the same marketing or brand name as total do. So a lot of patients don't really see us as being part of that group. So anytime people bring out marketing and all that stuff, it's a bit of our frustration because we kind of get left behind. And any branding material they send us all total branded which is kind of used a small point of view. So we've done very well by growing it and now that I've been there coming up to seven years, growing the name and growing the brand and even though it's a Bupa practice, I still feel like it's my practice because it's my name on them, do the majority of the work at that practice. So the really, what the practice is, I feel like it's me. So some patients will come to practice but then they're also coming to see me. So even though it's not my practice and I'm growing the EBITDA and the brand name for Bupa, but that's fine but it's I'm getting a good end of the deal as well. They always say, 'Soci, it's quite good because I don't have the responsibility of dealing with staff but I feel I've got the bad end of that because I deal with staff because I want the staff to be happy. It's your goal to go private?' No, well I, two things, I think a lot of my private comes from the NHS, the patients that are being referred in and when the patient does come in, I am very happy to go through the options and say these are the options, this is what we can do, this is the NHS option, this is the private option and just let them decide. I don't want to be in a position where I have to sell treatment. I don't want to be in position where I own a practice and it's fully private and go, 'Oh, I've got bills to pay this month, I've got this to pay, I haven't had enough starts.' That patient that comes in for a consult and back of your mind thinking, 'I shouldn't really be treating them' or you change the plan to try and suit them because you want that start coming in. I never want to be in that position, I love my job because I can sleep at night, I can just, I've done ethical work. But it doesn't mean that you have to be unethical, you could be private and ethical. Yeah, I think with all those different because we're competing, private author, you're competing with free NHS if they qualify. So I like that position where for me, when a patient goes ahead, it's not about the money anymore. Is it not that as an author don't, you can't do what you want to do on the NHS? That's true. That's very unethical in itself, isn't it? You're having to do treatment that isn't as good as you could make it because you've got an NHS payment system that's true. I mean, as someone like you, who's a well-known author on tissue at the top of your field, completely do my head in. It's true, but I think also the flip side of that, if you didn't have the NHS and those patients wouldn't be able to have any treatment at all. So in the fact, you can't offer something there. And actually ultimately, the end result of, I kind of say, to patients, end result is going to be roughly the same. You go to these conferences in America and the way they treat people there is totally different because the NHS can't. I guess most of what you're doing is extraction. No, not certainly. I'm very pragmatic. Or, on the other hand, I would treat what needs to be done. I think I go to these conferences, the ones that treat everything non-extraction. In my view, as bad as everyone that treats everything with extraction, the old 80s, orthotics of 4/4/4/4 on the floor, or 4/4 if not why not. I think that's wrong. It doesn't mean you do extraction on extraction with those NHS or private. So what do you do differently? So different appliances. So obviously, in Vizeline, ceramic appliances, you're more kind of do the service. So trying to have more kind of obstacle availability appointments for private patients. I re-letting them book a couple of points ahead. The NHS gets quite busy. Sometimes they may be seeing every nine, ten weeks between adjustments as opposed to every six to eight. My, we're quite likely have therapists. The therapists can work in orthotics and it works with us. We can make the NHS work because the therapists do the NHS treatments. So there's that aspect. I do a lot of fixed functionals as well. I think the one thing though that we can do better and we go to America and it makes a big difference is maybe some of the early treatment. I think the in the NHS it doesn't really pay to do early treatment and therefore I kind of slightly, apart from the anterior crossbite, for me if I can't offer an NHS option as an alternative, I then don't almost don't offer it as a private option unless they inquire and ask about it. But I think the flip side of that, you go to America and there is a lot of overtreatment early. They call it patient capture. You treat them at that age because you know they're going to come back at 11, 12, 13 and they're doing all this expansion treatment and all that. And some of the patients do benefit from it but others don't. And so I think there is an element of potential overtreatment in that system. So I think you know about
balance between both is because like I've got quite a lot of use on it. Well, there's a funny thing man, you know, since I've become apparent and I've had my both my kids go through author, makes me think if we're talking from the business perspective, it's such a winner. It's your kid. Yeah. And then as soon as your author thunders mentions your kid's face, that's it. I'm like, take my money. You know, it was simple as that. And you know, this all thunders knew who I was, my wife's a dentist as well. And both of them. Yeah. The moment they talk about your child's face, that's it. You know, I paid seven hours a good for author for that reason. Yeah. So what I'm seeing is from the business perspective, it's just truly talking from business perspective. Yeah. It sounds to me like private authors, one of the easiest businesses in the world, man. And I think if there wasn't an NHS orthodontic system, I think it definitely is, it sells itself, you know, it's, I, when I, one of the reasons I wanted to go into author, when I did dental school, it was the whole kind of everything was veneered and stuff. And my head, I was like, you can just straighten them and widen them. And it's that, you know, there are risks, but the risk is very minimal and what you outweigh. And I think from my point of view, it's not just the strengthening, what I see with some patients, which I think is, it is amazing, which isn't talked about enough is that they come in and they really care about their teeth and not really looked at their teeth before. And they kind of have braces because their friend had braces, they get referred in. And while they're in the treatment, they, they have to take their brace off, the amount of patients that I see, they're all hygiene has improved massively. They suddenly care about the teeth, they only want to go to the dentist to get that done, because they suddenly value their teeth, which they never did before. And I think that's massive. And we have patients that come in and the parents are like, well, I never had author, I never want my retainer, I want my kids. And we do things for our kids that we never had the opportunity for and our kids will do the same. So yeah, it is emotionally, it's, it's difficult. And then it's also that balance of sometimes saying to patients, I need your teeth, aren't that bad? Like, I'll be honest with them, I'm like, yeah, we can prove this a bit, but they're not that bad. And, you know, some of them will go ahead and say, and some of them don't, and that's absolutely fine. I don't think we need to treat, we treat everyone. But that's going back to saying earlier, if I had a private practice where I was solely relying on the private income and I've got bills to pay and staff to pay and maintenance pay and we've had a bad month, am I still going to have those same views of going, no, they're not that bad or actually, I need to pay, I think this month will pay staff this month, maybe we should do the treatment. So I think, um, I still take issue with you, the, the always conflating that with private and streaming. If you're a dishonest dentist, yeah, in any system, you'll do dishonest work. Yeah. If you're not a dishonest dentist, in any system, you won't do dishonest work. I think the different motivations are all there for you. You're in the NHS, you could use cheaper staff, you could have short appointments, you could have longer spaces between them. But I mean, if you're dishonest, you'll find a way. No, absolutely. And I tell you guys, maybe it's my slight risk of worse aspect of it, but I think with it, I think because with author, you do a great job and that's it, the patient's done, they're not paying anymore. While the general dentistry, you can keep it on a private plan, you just think, well, I've got 10,000 patients on my books, that's the me done. I can do whatever I need to do. But I think when you finish one case, you then you've got to wait for the next one to come through, it's kind of a conveyor belt. And if you've suddenly finished all those cases, there's less patients coming through for whatever reason, then I think that's when it becomes more difficult. If it was me, if it was me, I would run ads around sort of five mile radius of private schools. And I'd mention the face a lot in the ads. Yeah. In ads you can't zoom in too much on body parts, right? But you know, it just, I don't know, man, it's from, if we're talking purely business, it just seems like it's a business that you could get enough private children, I think. Yeah. Because you don't need that many, do you? Like, I mean, how many patients does a private author on this need in a year? 200, 300? Yeah. It's not that many humans you need to convert. It's not, I think also at the same time I like doing this because I don't want to be just treating ITN2s all the time. I like the complicated cases that come through and the big changes. And, you know, I would be quite disheartened if someone that comes through and I said, we can do this and then they go, oh, no, we're going to go somewhere else because we want to get that, which is absolutely fair enough as I had our top opportunities to change this. I think having a, I think, yes, business points, if you agree, but I think from a whole some point of view, a point of view, what makes you happy is how many years did you, do you being a dentist before you decide specials, or had you decided to specialise very early? So I wanted to specialise in dental school. So actually, before I remember my interview, I mentioned I wanted to be an author, only because I. You'd been through places yourself, or something? I didn't actually know. No, I was never referred. I did my work experience with a dentist who did a bit of author. He had a small kind of due descontract, and I thought, oh, that was alright. And I thought maybe in an interview, it might sound a bit different by saying I want to authorise. Where did you grow up? I grew up in South Wales. And then I went to Union Inn Liverpool. Cardiff, South Wales. Cardiff, and then Swanley. So we came to this country, we were straight into Cardiff. So we did your cardiff at Iraq. Oh, good. So it's quite an interesting story, actually. So my dad, both my parents and doctors, my dad was doing national service at the time. And to get one of the top jobs in Iraq, you've got to come over here and do a fellowship for two years. So we did, he got applied, got in, came here to the clinical attachment in Cardiff, doing the fellowship, being funded by the Iraqi government, two months in, Iraq and Batesquit. So all hell breaks loose, sanctions, funds, we'll see, no more money was coming in. And suddenly it was like, what do we do now? So hold with you, five. And my brother was two. And at the time, I just think, is anything of it, you know, but my mum, she tells me stories now that every time I was in Auckland, she just literally thought it was the police or customs sending us back home. Luckily, my dad was a very hard worker and he was very experienced and they just wanted him. And it kind of the consultants started to keep him on and he read the restraining we ended up staying. So actually for us, it worked out very, very well. And then that got consultant job in West Wales, we moved to Swansea and then, yeah, what kind of dog sozi? An ecologist. Yeah, yeah. So he's 70 and he probably works more days than I do still. Yeah, I do for he's sometimes working five, six days a week. So yeah, so growing up, I, they were like medicinal dentistry pick one. I know. I was like, okay, you know, that classic iron mentality. And I did work experience in medicine, I kind of thought it was all right. I did it in dentistry and I thought, actually, it's quite nice. I've always like using my hands. I've always like building stuff growing up around like the sciences. I thought, okay, I'll go down that route. And I wasn't the most studious at school. I was quite, I did the bare minimum to get through. And I think I probably, when I first went to dental school, I probably had the worst GCSEs of all are beer. A levels are kind of scraped, scraped through. And then I wanted to start dentistry school. I was like, okay, I'm, I enjoy this. I like this. And I think I got distinction in second year and suddenly I was, oh, okay, I can do this. And we had a fantastic professor in Liverpool who just came over from Lee's guy called Professor Kalam Youngson, who just had an MBA last year, I think, which is very thoroughly deserved. And he was someone I had, I hold on a pinnacle because he, I'm not pedospor, he, was, fans, and he just made you feel like you were really good. I remember did a couple of cases and I thought, actually, I want to do more than just general dentistry. So I actually did a really fantastic restorative wear case with him. And I loved that. I love complicated dentistry on patients that lay, just get on with it. So I knew kind of I want to specialise. And yeah, the whole author aspect we did also in dental schools really can fall to that module. And then went to it and I was like, did they really teach it in dental school for a while? This is awful. This is so boring. I don't know. So kind of thought of maybe I'll go and do restorative and then add a meeting with, with prof. And he's like, maybe you need to, you gave me a career plan of what you need to do. You need to GPT, potential hospital jobs and get, get a number. So I did GPT. I put a new castle. So that was a great program up there. I did one week on one week off. And this is fantastic stuff. And that point then kind of weakened my liking for orthotics because my GPT training did some more though. So I actually did a couple of cases with him. And I knew I wanted to specialise for me. I felt like I had to have that validation that I'm a specialist in the field. And I really enjoyed restorative and I really enjoyed ortho. Why? Because of your parents. I didn't just parents, but I think because if you were going out as general dentist and you had all these different courses that were available and all, I was like, where do you start? I needed to have that structure of you do this onto the next stage, onto the next stage. And the whole restorative aspect and the time, this is kind of just before the monospatial and the monospatial aspect coming in. It was all seems to be hospital based and consultant based and I knew I liked working in the pace of practice. So then with orthosis of orthotics I actually really enjoyed that as well. And so I just got go down that route and then I met my wife from south. She didn't move up north. So moved down to London, did maxbacks and did peed and got into ortho and from there. So I kind of knew early on I wanted to specialise. So where did you do the M-orth? I was split between guys in Brighton. So I was at WEEK at Guy's and a WEEK at Brighton which was great because there's two very different units. You kind of have a distra general. We learned a lot of the ortho and then Guy's was an experience because some of the cases were coming through that. But also you were left a little bit more on your own at Guy's while Brighton you were kind of more, you know, the consultant's right next to you doing a clinic. So I learned a lot. So I want to talk about the M-orth in detail, especially because there's so many people considering it. But I want to rewind to Liverpool. Yeah. What kind of a kid were you? Were you like party kid? Were you like Dr. Studios? And I was a bit of school.
- I never drank any of us, so I don't drink now. But because of that, I was end up being out most nights because I don't have hangover the next day. So I was very sociable. I enjoyed going out, I enjoyed that aspect of it. And I thought-- - For the first time you were away from home. - Yeah. - Yes, first time I went home. - When you were a poor, good town. - Great town. - Yeah. - I've got great memories there. Fantastic five years spent there. - Great. - I think the people though, quite similar to South Wales, they've got this sort of warmth to the family or into each other. - Yeah, very friendly. - And funny people. - And great people do do to practice dentistry on because they just let you get away with anything. You know, it always gets dead matter. So yeah, it was a great town. I was, I think I, I can't quite similar now. I try and do both. I try to work hard and play hard. So for me, I'm not very good at sitting still and doing it. Which is why I've got done all these extra things from finishing. I was always right, let's get the work done and then let's enjoy. And I kind of grew up that with my parents because I like doing all these things but they were forcing me to try and get work done. So for me, right, well, if I've got my tennis coach and that after, if I've got a goal, or I've got football, whatever, let me get a few hours of work done and they go and do that. So for me, it kind of all, I've always had that. So I'm going off to uni for the first time and being away from home was, yeah, I absolutely loved it. But it was quite nice to have that balance of, I think the not drinking was great because I drove, you know, cost me anything. I drove there, drove back. I was the designated driver. But then I had different group of friends, I had my dental mate, I had my halls, the residence friends, so it kind of almost go out with, you know, throughout the week, with different groups and then getting to know different people. So, yeah, really loved it. And then it became, when you get into third year, you start doing clinics. - That's a bit serious, suddenly. - Yeah, absolutely. So, again, you know, going out the night before, but didn't matter 'cause it's like patients the next day and you weren't drinking or hungover, you're still kind of being able to do it. So, no, it was a great time. - Let's talk about mouth. The thought process, especially now, becoming an orthodontist now, a bit different proposition to, in your day, and in my day before you. Because in my day, if I can characterize it, it was like the top two or three kids in the class of dental school would say, they either want to be orthodontists or surgeons or something. - Yeah. - And the orthodontists would have to go through a bunch of crap, difficult life and do the emul, but almost promise that the end of it, a brilliant career, loads of money, not risky in that sense. - Yeah. - Today, when almost every dentist is doing ortho, it's a whole different proposition, especially as people don't want to refer out of their own practices anymore. - Yeah, no, absolutely. - So, take me through the thought process. Did you have any thought process about, you know, what it will be like to be an orthodontist? Did you talk to people about it? Did you go through that thing that I went through with what's your friends buying pauses? Well, you were still studying? - Yeah, it was. It was difficult. I think at the same time, it was kind of, just always the next stage. So it was, did Newcastle two years find, move dance on Did Max Facts, enjoyed Max Facts, and probably-- - Did you do? - I did. It was an experience. And I think, after you do Max Facts, I hated it, man. You'd never, I did it the Royal London, and I remember two months in, I was on call New Year's Eve, and it was an absolute war zone. - Yeah. - But after that night, I was like, nothing's gonna stress me out. - Yeah, that's true. - Once you get to-- - Makes a man of you, right? - Yeah. And so it was great. So that year was a bit of a blur because it was so busy. And I applied that year, and I was ranked six, I was staying London, because more often I didn't want to move out. So I was ranked, there were 15 places in London, I was ranked 16th, so I just missed out. So then the Peds at Guys, just to get another job there, that bit was a bit this heartening, 'cause I was like, I was almost there, and that could have been me. But it worked out really well because I ended up, because I did it at Guys, I put Guys in Brighton's my first choice, talking to Copper Friends, it was a good choice. So I got in that year, and the three years at MWF, I probably had a very different experience to others. My son was born two months into MWF training. So, the MWF started October, and my son was born November. - So is your wife then this as well? - No, she's a GP, she's a doctor. But at the time, she was doing her anaesthetic training. So it was three years of having a kid, my wife working on calls and nights, and doing everything else, and commuting to Brighton, commuting to Guys, and everything in between. And I was working Saturday morning in general, then to practice. - As well. - As every other Monday when I was at Guys, I was like, - Just to pay the bills. - Just to pay the bills, just paying nursery bills, nappies, all that. So. - And it was MWF quite a difficult course. - It's a lot of time. Reading essays, cases, 'cause you have to present five cases to a great standard, then you're gonna write those cases up. And then the research, you've got them to do a masters with it as well. So you've got the research aspect of it as well. So it's just complete time management. I want to say it's difficult. I think you've got the work and you'll get that work. - Would you say it's fit for purpose, considering where we're at? - I think it is. For the reason that those three years, you are living breathing, treating orthodontics full time. So that, all that, did you, master your thing, you've done 10,000 hours, and that was a good chunk of 10,000 hours in those three years. You are with other orthodontists, you are with other trainees, you, every day, you are living and breathing it. So when I was on the train to work, I'd be doing, I'd be reading papers, I'd be writing up essays, and then on a train back, I'd start that and probably end up falling asleep, halfway through. And then in the evenings, when my son did not sleep in the evenings, unless we were in the room with him, so I would sat on the floor, in which he was, this would have been between 2012 and 2015. I was on the floor on my laptop doing work, while he was sleeping in the cart until he slept, because he wouldn't sleep unless I was in room with him. - But for instance, did they teach you aliners? - No, and that's the thing they don't. They don't teach you aliners, they don't teach you, but they teach you bog-standard biomechanics, and working with different things. - They do, that's crazy. - Like, - Yeah, - I don't like that. - They do still moving teeth, and it's in the foresome teeth and all that. But it is madness, isn't it? - Yeah. - But all the don'ts are sat toward aliners in their mouth. - I know, it is crazy. And actually, if you went to America, they do teach you all that. But I think the sheer number of cases that you treat, itself is. - It's gel-b-t. - And if you just know how to move teeth, and then you can then apply that to aliners. And actually, and that was one of the things when I went to the first conference. I went to, I was first or second year, Reg was over in America. My consultant came in and he thought, "If you publish this, "if you write this as a case report as a poster, "and get it published, "kings might pay for you to go to America." I thought, "But, you know, a week away, "it's gonna be able to do that." And I went there, and that really opened my eyes to some of the stuff they treat. The, the American conferences, they do things so big and so great. And I remember looking at the thing, and it was, "Heuily was in the news." And I just thought it was a tribute act. No, no, it was actually "Heuily was in the news." - In there. - My brother's a radiologist. - He went to the Chicago radiology event and the Barack Obama was thinking. - Yeah, Jay Leno was that. And it's just mental. So you go to these lectures and you see all the big boys and all kinds of speaking and then there was a massive aligners actually. That time aligners were kind of, we're still fairly new in the sense that this was, but it's been 2012. So there was there or there, but there was a bit of skepticism in the author world of what aligners could do. But then you go to those lectures and you go, "Blue my mind, some of the movements "that we're doing with aligners." And then when I kind of after two years into author, then finished, I stopped working Saturday morning in a general practice. I was just actually bashing the gnash as they say. On, it's Thursday, I started a, an auto job, so still training, but I started an auto job in a little niche practice in Chizek on a Saturday. And that's when I thought, "Well, I've got to start doing aligners." But I could go into it because I can treat my plan, I can do everything else. But at the same time, if it didn't go to plan, I could put a fixed on, I can do that at the end to get the patient to the point where we want to. So even if you'd messed up, having quite done it properly or what have you, I always put, they always did a lighter or a full, I put everyone through as a full because I thought, "Well, worst case, "I can just keep refining until they're happy." Also worst case, I can put a fixed on at the end. So I had that knowledge and that's what sometimes I want to see some dents that do a bit of also do a bit of invisibility. And then maybe you have, if you have what goes wrong, when it goes wrong, if you can't put a sectional fixed on, what do you do at that point? - Refer, right? - Well, then is the patient going to be happy that who's going to pay for that? And so I think, and that's when I thought, actually maybe I should start doing my own mentoring and teaching because dents are going to be doing it anyway. And when I qualified, there was a whole host of things about six months miles was massive at that point. And I remember the couple of dents that did it in the practice that I was working on the Saturday and they'd be booking out around the half or an adjustment and then seeing the patient every four weeks. And I think that's not, one is not efficient, two is done what you're doing. You can't go on a weekend course. And there was a, remember seeing advertised somewhere that, you know, it was like comparing specialist orthodontics to this dentist doing six months miles. And it was like six months for them, specialist was 12, two years, white brace for them, specialist was methalcate, you know. And I'm thinking, you know, all the studies show that how efficiency orthodontics is about experience, not about anything else. And so you're coming out of that and you're thinking, and people, you could know, doubt there was going to be a trouble doing it. Purely because they don't, you don't know, you don't know. And I remember how the, the whole fast braces thing was out and all this stuff. And fast braces was a triangular bracket brace that essentially, they marketed to orthodontists. And in the orthodontist reactions doesn't, there's not much difference. And then they've moved away and marketed to GDPs because they might,
not know any better than them and then I was on Facebook and then I was then being accused of being a protectionist. I was like, "Oh, the issue is not, you'd not doing it, it's you're not getting a training to do it." You would not put an implant in by just doing a weekend course. You would do surgical skills, you build it up and I think that's what I was looking at. And I think because also because sometimes looks straightforward, it's quite easy to go, I was just really on as the clinch act shows this and well, it should just get to that. But if you don't understand tooth movement, I mean, I'd say well, I was surprised about ortho. We made a little for a into ortho where we thought about it. We didn't do it in the end. We thought about it. And I didn't understand the market very well. So I asked someone to gather the top orthodontists in the country so that I can talk to them. And it amazed me, first of all, that I don't know why we think as generalists, we think specialists don't get themselves into trouble. We just think, "Specialists or thunders, it's going to be fine." But it amazed me in the detailed conversations with them, but you guys get in trouble too. It's such a weird thing because you just think that's not the case. No, but also they need to be able to treat them more complicated cases, while the ones I can go, right? And I get a bit of a bit of trouble in the novel you do. I think you can say it. We just don't think that. The other thing is we think as generalists that there's only one answer and there isn't. It's just like, just like if you put 10 dentists in the room, you'll get 11 treatment plans. Same thing with orthodontists. Yeah, absolutely. Two different opinions. People do things differently. And the other thing that was really surprised me is the egos, the egos in orthodontists are even bigger than the egos in dentistry. You can see why, right? You can see the reasons why that might end up being that way, with everyone being top of their class or whatever. Yeah, absolutely. And I think that's where when a line tried to come into the country, they tried to kind of go down the orthodontist route. And obviously the ego with the orthodontist was like, well, no, this is not going to work. This is a removal of appliance, removal of ones only tip teeth and all this stuff. So then they kind of opened it up to the general dentists. And there were some very good general dentists that took it on early on and do some fantastic cases and work. And so yeah, I think if you go to other places, you know, in business, I was really only opened up to specialists, but because in the UK, I'd done it for tar training. I'd done it as you said, the top one or two that get in and do it. And so yeah, it's an interesting kind of, you look at those egos and then but then you look at those cases and you're like, well, you know, and I've gone to conferences and I've got that, you know, they've shown the classic example I find is the missing lower fives and the ease and place. And they've done these fantastic mechanics, put tads in to measelize that six, you know, it's a class one case, for example. And they've done all that. And you look at the end result and go, yeah, but now you're up to sevens completely unopposed. So you've measelized the six measelized seven, pack yourself on the back, fantastic result, beautiful class one, got rid of the missing, and you look at and go, yeah, but now that sevens are interrupted, unopposed, it's not doing anything. What were you achieved? But because there's so much enticing there ego of this is what I can do. Yeah, just because you could, doesn't mean you should. So I'm very, you know, I think I'm just talking quite a pragmatic clinician. I also think, I think the classic door to test, I think that was probably one of the reasons why I went into orthodontics. I think the, you know, would I want to have, and at the time when I was doing my, you know, end of finishing dental school, it was the whole souvenir, don'tx and all that aspect of it. And I was, I don't know if I'd want that. And actually, with ortho, yeah, do ortho. So I think that's what the reason why I got into whether I was a bit risk averse or not. But if you tried dental monitoring, I have. And I can, they keep kind of contacting me about it. So I can see the benefits. And I think from my view is the, with my liner cases, right, you see some liner plans that come back and they're like 60, 70, 80 liners, like you, that, they're not, your patients will lose compliance halfway through, they're going to lose tracking halfway through. So most of my kind of plans are trying to limit it as well. I'm doing 30 to 40 for the first time. I always accept I'm going to do a refinement because I'm breaking down the two movements and being able to reach a risk. And so then my view is if they're, I know within six, eight weeks, I see them after the third, I see them at six, eight weeks. I know within that point whether they're wearing or not. And if they are, I can leave them eight, nine, ten weeks. They can come back at any point. And, and the ones that I'm bit has an out, I'll see them at six, eight weeks. But I think the other reason why I didn't kind of go down that route is because then I just felt like it was a bit too much like Smart Direct Club, you know, here are your liners and, and see you, see you later. And so I thought you were providing service. You know, I think that's the reason you've got a bed in mind something. Yeah, that I might, my son went through traditional athletics. Yeah. And my daughter went through Invisalign and Dental Monitoring. And from the patient perspective, the fewer appointments the better. Yeah. Yeah. Pain in the arse, man. Yeah. Yeah. I mean, my son had to give one going to Harley Street, paying, paying for congestion zone parking every eight weeks for a little tweak. Yeah. Yeah. Yeah. But we're dentists, right? We think the number of minutes you spend, number of hours you spend with that patient is what they value. Not the solely murder. No. And I've always said, I've always been meaning to kind of go down the route of, okay, I'll give the patient the option you can come every eight weeks or you can have Dental Monitoring. And I tried the Invisalign one that the virtual care and I just found that I was, I'm, I try and delegate what I can, but I thought it'll just be by the time I then train the nurse order to do it, and then me going through it again anyway. And I just thought it was just an extra thing for me to do. And so I'm still might looking to, I think the, I also think Dental Monitoring itself, I think it's great and some of the things they might be doing with potential scans from being able to do a refinement from the photo. So I think that's going to be a game changer. I think I might look into it, but I was never a full early adopter with certain things. I kind of want to let other people get the fingers burned and then pick it up a bit later on. But also like I said, I like seeing my patients every eight. I like to get into them and chat into them and you know, it's providing that service. And you know, okay, there might be some patients that they don't want to come in and maybe they're not the right person to come to me. I'm not there just to straighten and see that I'm there. I'm a provider. I feel like I'm providing a service for them and getting to know them. And purely from a, it goes up to why else do I do the job? It's, you know, it obviously pays well. But there's an element of, I want to see patients at least say, it's only, you know, it's really the ones that you like. You get to know them, you have a laugh and joke. And actually the line appointments are quite a nice appointment to happen because it breaks up the day a bit, sort of fixed, fixed, fixed and have a nice little chat with them, check the, you know, and so I think that aspect of it is why I haven't fully jumped into it as well because I just, you know, whether they may not want to see me but I quite like seeing them there. I'm just for a catch up and see how they are getting to know them. And I think that's because otherwise if we are treating patients, you know, otherwise it's just objects, isn't it? So I think for me it's why I like this, why I go to work. It's the best part and the worst part because you do get that one patient that, for instance, the bit I miss the most is the conversations. Yeah, patients. Yeah, I stopped in 2012. Yeah, I miss that. Yeah, I don't think you missed the teeth. No, no, no. That's why in line is quite nice because actually I'm not shocked with them. What effects comes you busy doing stuff and you can be upset you talk to the parents and the dead, but if it's the kid or the patients, it's only them, it's hard to tell the conversation, you need to adjust in the effects. It's a much easier to tell the conversation when you're doing their, their aligners. Let's talk about the academy with particular reference to I'm not going to kind of understand where do generalists go wrong with ortho commonly and what a common sort of unlocks. Yeah, I think the biggest thing is you don't know what you don't know. And I think if you haven't done a plan, the classic example, and that's where six months of our patients were running to trouble, two to two full unit buckles, like my relationship, I know you soon just right in that up, you're going to get increased over, right? But not all dentists know that. So suddenly now the patient has gone from gravity to having this stonking over, not consent for it wasn't picked up. I've probably got the same result. The difference I've explained to them at the start. And as we can manage it this way, to see if they're out or surgery or accept it or whatever. But if you say to the end, it's an excuse to say, why, and it's consent. And I think that's where they're in trouble is not knowing that. Other aspects is in vis-line clinchex, as great as in vis-line is, I can show you any clinchex that will show any movement occurring. It's knowing the predictability of the movement, it's knowing what it can achieve, because it can allow you to a false and security where you should see this plan that you move in these teeth in this position, you're doing all this. And then yet, but it's not happening in the mouth. And I thought, well, there's that disconnect. And why is that? And you can tell before you start that that particular movement is unlikely to happen. Yeah, just the way the clinchex is saying that. Absolutely. We know the predictability of certain moves with the liners. And I know from looking at the rotation. What do you talk about rotations? So yeah, rotation, very heavily rotated teeth, particularly canines, small latches and sizes. We always lose tracking latches and sizes. We know closing spaces, so I do extraction cases with liners, but I add extra things into our power arms, our larger attachments or over-corrected movements. We know intrusion works better than extrusion. So if we're trying to correct an AOB, we'd want to try more entry the poster instead of just purely trying to extrude the anterias. And so it's kind of it's known and I know that from looking at the patient's mouth, what the predictability is and being to visualize it. So then it's then transferring that to, okay, it contains the patient we can do a liners.
This is what we'll get to and either you're happy with that and that's absolutely fine No, if not we could put a sectional fix for a few months at the end, right? But it's explained at the start and I can do the sectional fix So even when I do align it when I have some patient and some events come to me I only want to do a line is only doing this line my academy. It's it's broad breath It's it's fixed and it's a lion is and you get a diploma You can take it as far as as much or as little as you want But you have to have a knowledge. I feel of least putting a sectional fixed on to be able to get out of trouble For that patient that that latrine size didn't quite rotate or the lower Insiders not fully there or the latrine size didn't quite extrude because you can travel these different things And if the patient at that point you down the line you kind of 12 15 18 months in treatment patients lost compliance anyway It's starting to lose faith with you anyway. They're not going to be wearing the line as as well as they should and I've treated some other cases where the patients were Dilligent with them, you know almost had a stopwatch over time And he had a spreadsheet of how many hours or minutes he had it out for each day and some of the results were phenomenal So it can do fantastic stuff if it's worn well and it's planned properly So it's the planning is the key thing the other example I get always was classic example is a meeting to ask the most a little spacing and theory each doubt bit about it in person to close that space up But if you haven't addressed the overbites Then we know space is one of the most things are going to open up again So you want to really want to put upon the retainer on but then there's no clearance to put upon the retainer on because you just treat it up for our Generally so the patient then breaks the bonder retainer the space opens up again and then if you haven't planned that retention from the start Again, that's where you're going to get into trouble. So seeing the whole patient as a whole as opposed to concentrating on just that problem and knowing the limitations and knowing how far you can get with each one and it's the planning and so One it was it was actually a friend's wedding a couple years ago and I was always I'm ignoring back doing the course I did a bit mentoring for for another company and he's a wedding set up your own course I was like I don't know if I you know I didn't like the idea of having booking out a conference center and and you know people coming in and doing it and he said no what about an online one and I was like Oh, okay, I got me thinking and So I thought okay, I could do this and I sat the whole list of lectures on to the cover I drew in between patients. I was writing all the PowerPoints on the weekend. I was recording They're just having it all all done and there and then up but the key things with author It's not the course. It's the mentoring that you did with it as well So and that's what I provide with it. It's all about the mentoring and and for the mentoring aspect where if it's a fixed case The photos are put up on the forum every visit. I would tell them what to the next one You get that before you even pick up any trouble You've picked up from the start. We see what the case is appropriate to treat we they put photos up And then give them to go through the plan and therefore you did my therapists Authentic therapists are a nurse that have never touched the mouth and they go on a four-week block course somewhere where they do Six days of phantom head if that and they come in straight back in and put in brackets on and all I'm doing is just telling them what to do each visit Well, these are dentists who etch and bond day in day out There's no reason why they can't do it if the plan is appropriate so And it's interesting it's come to me because I'm doing this line And it's what can it can it's what does the duty say say about be doing fixed braces? I was like well the duty isn't say anything about you doing fixed brace The duty isn't say anything about you doing a line is it's if you're doing a line is orthotics There's no difference just because you're doing a line is it's okay. You won't get in trouble No, no, it's no different. You are doing orthotics and the way this country is I can place an implant tomorrow But if something goes wrong, I've got a backup my theory and it's no difference with that so It's given them at the piece of mind and I've got some dentists who are my mentoring who do loads of cases They probably did more cases and some orthontists But they still want me just to keep an eye on it and and it's the easiest thing for me in the world to do because actually Their plans are already spot on they already know what they're doing. I'm like yeah, that's fine Yeah, that's fine that's fine. Yeah, it's fine And then I'm then given the tips and had to be more efficient in a treatment So there's a whole host and there's a whole breath that ones people just starting out And I love teaching I love seeing that and I had one of the first ones that signed up to the course It was a case she's like I've got the patient wanted to fix. I thought it was gonna be a line is I thought it's fine So I put some brackets on pla it's all online So I put some brackets onto some plastic study model Glow on take some photos. I'll give you feedback. She did it. I said fine. It's no different to that And what I saw her post on an Instagram that is the first cat and she was so proud of it I was like I did that. I really that was the thing that I actually actually really enjoyed this Seeing them grow so Take me down the total beginner Hasn't done any author. Yeah, if you've got a program for them. Yeah, yeah, and there's a different program for someone who's done some author before Or do you just stop I'm gonna start being because I don't know what they've covered Yeah, so if they've already got a diploma elsewhere, then that's fine They can go straight on to the mentoring program where they can either pay per case and I'll just guide them from start to finish whether it's a line is all fixed appliances Total beginner the course is all fully online all the modules are covered so it covers fix the covers aligners it covers everything All the and easy. There's even procedure video. So how I do a real time one the power to real time more than retainer So covers everything start to finish it even covers things like kef tracing is also I just make it as comprehensive as possible almost the level of what I did at M Earth and And for the most straightforward cases at the end of it they'll be able to treat it because I'm there with them You know if it's an extraction case of our performance and or a functional case then it's it's not rocket science doing the author It's the plan behind this so how long how long does it tell me how many how many modules is it like so there's seven modules and it's probably about 35 to 40 hours worth of video But the whole total in total and but the whole point of it is I don't you go to some of these lectures sometimes and people are recording the whole thing I said well they can stop pause rewind as many times as you need to I've written loads of resources in each one So there's loads of extra information where to read about and but the whole point is then it can go back right I've got that on the today. I can go back to that video and see how's it it is bond up and then it's always there's always available and the mentoring is extra It's included so with the diploma you get 10 cases that are included and then you can always pay for extra cases after that so I try to do it so it's So what is it cost? So the diploma is 8995 at the minute it's including that because we're not be able to register yet and we're on the verge of that I'll worry about that one that happens and you get 10 cases and you need to get diploma but it's much cheaper than other diplomas around because partly because it's purely online You know don't know and I what I did lecturing for other courses I spent the whole time in a room with Seven eight people have come all over the UK Given up three four days of the of their time and clinics and seeing being away from family and sitting at hotel And I'm just in front of a PowerPoint the whole time and the only practice was sticking brackets onto plastic teeth It's not like implants we have to learn to do the skills and that aspect it's literally the planning and I'm practicing on patients You know my amor I learned from practicing on patients was never practicing on phantom head or doing pigs models or anything like that it was on actual patients so Yeah, so you'll be able to kind of start from day one and because then it's online There is no cohort and like you've got to start in September or start in April It's you can start as soon as you want it's all automated as soon as you sign up you get going straight away And I try and do that the minute I'm keeping I don't know it's the right thing or not I keep it personal so everyone that has the signs up has my WhatsApp number get messily I was able to watch all those able to do because for me I'm doing it to To kind of get to know these people to then because then I get to know them I then get to know what plan They're able to do because I know what level they're at you might have two different dentists that come in with the same plan It might be different. I was actually maybe refer this one out for one or they look I know So you know payments really good. He'll know what you need to do. It's absolutely fine He can treat that patient because then I get to know them and because I get to know them I get to know what the capable of and for me You see them grow from the start to where they are is is what I enjoy out of it and my views that dentists are gonna be doing it anyway The Mars will do it properly But they're the gatekeepers. They're the ones that they're supposed for that nine grand I get the all the education and ten cases just in cases and an diploma and Yeah, so So what does that mean the diploma? So you get a diploma of thonsox just so you can you've got something that you can show patients that you I'll get a diploma. Yeah, and then if I want you to mentor me for ten more cases Yeah, how much is that so I do different packages so do 350 per case or 900 for three or I do a monthly subscription So I have it's just under a thousand a month for unlimited cases. If you're going to do lots of cases then yeah a thousand a month or you can do two cases a month which roll over for four and a nine five pounds So depends on how many cases you do you need to be per per case or all the unlimited Plan so I got some then started on the unlimited plan and They're very very good all the ones they do a lot of cases and It's I had around having a meeting someone like that's a lot unlimited. I was like yeah, but it's if you are on the unlimited plan You're doing so much or so you're getting so good at it You almost don't need me as much. It's my job is just to keep an eye on it and just go. Yeah, that's fine That's fine. What the one is just starting out. It's okay if anything is more time because I'm gonna spend explaining everything and That's interesting and the reason why I did that those videos is that oh, how do I do a quick like oh watch that video module six There's how to do a quick look so it's not there someone's been in I did that course purely as it as an adjunct to the to the mentoring And this is all before the days of AI so you had to get like a software guy to help you Programmer, yeah, yeah, so I'm actually really proud of the website because I made it it's all automated So anyone can sign up pay the money straight and they get instant access to the to the course Like it sign that straight away they get notice the mentoring forums all done. There's videos on how to do they get an email with a video Of how to onboard and so I've done I spent the time making it so it's fully automated I should like get a long time there all of it together. Yeah, yeah, but I've never been good at sitting still So I've always had a project on the go. I've always done something throughout my career alongside it because I I am so bad at sitting still when I finish work. I have to be doing something So I'll do the take you You
- Oh, pretty good. - Yeah, yeah, yeah, about a year. So I probably started it in summer last year and I kind of launched it in April. The bit that was a lot of work was getting everything ready for the diploma because it's kind of the learning objectives and the assessment criteria is and how to set the all up to get it through EDGYKEL. That was, but I think then it just gives it a bit of validation that it's actually a good course as opposed to, 'cause there's so many online courses nowadays. - So you went through that process. How did you get your first customer? - So I had some denses that following that I did mentor on a previously. So I kind of tried to be pragmatized. It's just a small world. I don't know, no, anyone. But I had, when I kind of did Instagram page about my Facebook, I was like, oh, is that you doing it? Can I join you? I was like, yeah, sure. And then, so that's where I'm at now. It's kind of where do I get people from? And I think eventually it'll be word of mouth that's getting and I want it to be word of mouth. And because I wanted to be all, I might get to that stage right now actually. We're closed now because I've got so many denses on there. I don't want to lose that personal factor. But the dentistry show, so did eventually show in Birmingham and did the recent one in London. So probably had the most from there to kind of get the word out there. Doing a bit on Instagram. I'm not very good at social media, so I do feel like I have to maybe get someone else in for that. But at the same time, I don't want it to grow too big, too big. So, but yeah, it's just kind of getting the word out there slowly really on that. I've had some denses come to me where on this Facebook group, someone was trying to give advice or help. I did, there's an authentic advice for GPs, Facebook group that I set up. And purely just as, yeah, free advice for them because I'm just quite like advice. And then how much of your weeks taken up by the education? And is it evenings? It's every day. But sometimes it'll be half an hour, sometimes it'll be an hour. It's in between patients. So again, what my nurse is cleaning up, I do my nose or see if my's a therapist. I'm, again, I'm not very lucky. We're not very good. I have to be doing something. I'll go on the check and all the evenings. If I had a really, really busy day work, I have an opportunity to do that. Then it's evenings all weekends. So, but I, - And you work five days a week? - Four. So, four days is reserved for the golf course. (laughing) Yeah, so yeah, do four days a week, but four busy days. And then just give me a bit more time to kind of do other things that I want to do. And I'd rather do, I could probably do five days worth of work in four days. And I just think it's more, when I'm at work, I'm at work. I'm full on straight in. And then, yeah. - Let's get on to the darker part of the pod. - Yeah. - Firstly, what's been the darkest day in this journey? - So, I think the, I've always been quite good at communicating with patients and sussing out patients that might be in trouble. So, I've always done very well to avoid big problems. And then you think when you've become a specialist in your 10 years into, you know, being a specialist, you think those days are over, right? And there's probably two things that come to mind. One that's clinical, one that's non-clinical. So, the clinical, it was probably about six months ago. And I had a patient that I was, I do a lot of fixed functionals. So, these are little springs which go onto the fixed brace. And I was removing the, she was finished up, of course, the treatment. And I was removing the fixed functional. And as I was trying to pull it out of the tube, it's like, it slips lightly. And then I lost grip of it. And there's an patient, the patient kind of got up. And normally they kind of take that and then I think of here it goes, you go, I swallowed it. And I'm like, what do you mean you swallowed it? Like she's a little girl, 12 year old girl, very petite. And the spring is about two inches long and half a millimeter, it's half a centimeter in width. And I'm there like, a little bit in denial, thinking she comes swallowed it. And I was like, you sure you swallowed it? You sure you didn't, you know, in hay, there or anything else. There's no nice swallowed it. So, it's like, okay, so I did the rest of the adjustment. And then, and then the patient went. And I might not have looked at me because you're going to do anything. I was like, fuck what do I do? So I looked at the be the Booper guidelines on ingestion, hidden haste. And it was kind of like, they got to go to the A&E. And I looked at the BOS guidelines. And it was like, if it's beyond the certain size or it's sharp, then you should take into A&E. But I kind of measured it out because we had the other springs, we kind of measured like, what is less than that? And I was almost trying to find the guideline that suited my bias. - Yeah. - And then, who's in the clothes the Thursday, who's in the, near the end, it's just seconds of last patient went. And then I was driving home and I'm thinking, you know, you crack yourself, you think what are the things that could go wrong? I was thinking, should I have told them to go to A&E? Should I have not, what should be the, what do I do? And I got home and I just had the worst night sleep. Couldn't sleep that Thursday. And normally, Thursday nights, I look forward to the weekend and I'm playing golf on the Friday. And then I was like, I don't know what to do. So I called the A&E on call near the practice. And I said, what do you suggest? And I said, oh, they should come in. I said, okay, now I'm trying to find another bias if I will happen, I've avoid this. And I thought, I can't do it. So I called the practice, I can give you the patient's number, called the patient's mum, she answered. And she came with that day, point before, I'd explain, she'd obviously she knew. And I was like, how was she? Because I don't know, she's fine, she's gone to school today. So my head, I was like, okay, what's she's fine? Does she need, and I said, look, I think it's okay. The guidelines say this, but I think it's worth going to A&E to get it checked out. And then she goes, oh, that'd be quite difficult. I'm like, what, she goes, well, you don't know, but she's going through a lot of anxiety recently. So first, she's actually been able to go to school today. - Oh, really? - So I was like, okay, well maybe when she gets back from school, maybe just go and get it checked out. But, and I never get my number to anyone, but I say, this is my mum number, please just give me an update. So there, the golf course playing golf, just had the worst rana golf in my life, just because I just couldn't concentrate on the thing. And then got a message from her later on, and was like, oh, it's all fine, it's passed. The, I think the pyrogues think this is what they worried about. It's passed, I should definitely inhale it. It's an all just pass through, and it's nothing to worry about. And that point, I was like, oh, thank God for that. So, yeah, I sent flowers and like a little teddy to her. But that was, and you think, you know, you think you get passed, you think it's a point where you know everything, you can manage that patient, you know, you're not a point where you need the money, you need the patients to go ahead, you're quite comfortable in your career, and you just think, I think, you know, I'm at that point, and then suddenly that hits you. And that's like, so that was hard. But I think what I learned from that is I probably should have handled it straight away. I was a little bit into night, I probably should have said to them, that this happened, maybe just go to A&E and just go check. So, and then why do you think you didn't just, I think I was trying to, in my head, I was trying to brush it over, I was like, it's fine, I'll be all right. And, and also didn't want the hassle of them going to A&E and stuff. And actually what I should have done, I said like, here, I'll pay for it, because I'll pay for whatever it is, just, just go. And I probably would do that. Now, but also it's now I've never been in a situation before. So I felt like I didn't just almost kind of fogged, you know, didn't know what to look at, even then I didn't know what I did on the next patient, I was just kind of like, hang on, this is, that happened before. And yeah, because the guidelines also the BDBOS one said, actually, if it's more of a certain size, then it's fine. And so when it came to taking it very soft, she was very anxious, because she thought it was going to swallow something, but they were very good about it, and she was fine. And so yeah, that was, that was what. And then the other, that's a non-clinical. It's a bit backstory. I invented a little erupted device. It's a very small kind of my, I was, for partially erupted cases, I was getting to the point where, when you may have a partially erupted tooth, you can't really put the bracket where you want to put it. So you kind of put it as high as you can, you're bringing it down a bit, and then you've got to repeat the two, three times before, the tooth comes down before you can put the bracket in the right position. So normally it's canines, come through or in fact, the canines that you bought through and exposed and bombed. So it was getting very frustrated with these cases, and I thought I've got to find something about it. And I had this idea, I was like, what if I can do this? I kind of made a little prototype, did it, and actually started, works really well. And then I was like, okay, I'm, I can invent something, and I thought I was going to be able to retire on this. And so I kind of went down that route of manufacturing, approaching different companies to kind of sell it, distributed, and to kind of get in the patent process, and then I was going, the whole patent process is, and now I realize why, so it's so hard to get something to the market, because the cost of the law is, the cost of the patent process, the cost of all that is ridiculous. And this is, it's not particularly expensive, and it's not every case needed, it's quite niche. So anyway, I was, that was all doing well, I was doing all right with it, I was kind of getting the word out there, and so I distributed it in all parts of the world, and then suddenly, what the German distributor, I get a email from him, and it's a season, this, this letter in German. So they're trying to kind of Google, how did you manage to get distributors? - Approach them, really. So when I found it, when I kind of had that idea, and I hadn't shown it worked, when I was at American conference, I went to the big guys, like 3M and all that, and they weren't interested in it. And they found a small company called Alure, or Thon-Six in America, and it was all this sounds like a good idea. They got their own Chinese manufacturer, and they said you can use it and we'll come to a deal where we would sell it in the next video.
in the US and we would you get a royalty and for the rest of the world you can do what you want. So they I call it the Esmeralor Raptor, I thought I'm going to do something on a name after myself in America that we don't do that anymore because of the whole Damon thing aspect. They kind of called it the rapid eruptor. I was like fine, okay. So they kind of helped me with that. So they kind of went down the road and then I just approached different distributors. So now we had a package where you can sell actually have my own shops of patients so people can then scan by it directly and the Facebook post here and there and whatever and and then to see now sell it in the UK. And approach different just so there was a German one I was at a conference or one of the German guys I was chatting to here's I got my friends at a distributor I'll put you in touch with him. So it kind of happened that way around and we're just kind of getting to what we're trying to get distributor per country and anyway so I thought it was all going well we've got patent pending and this price takes a long long time so get the ceases this is letter and I'm like what is this and trying to use Google Translate to kind of translate it and at the bottom of it it was like they want a fee of 500 I think like 500 euros or a thousand euros or whatever it was and I was like I'm I come well doing the headache of this you know I don't need it I'll stop distributing it in Germany and pay them the fee and the apologies. So it gets my patent lawyer and he's like no no no I'm like what do you mean is like they're asking 500 euros per pack sold and there's 10 each pack because they might even be per piece sold and I think we only saw like I don't know 200 packs was in a huge amount and you know we start thinking what like and then I'm thinking so that's what they wanted to kind of make it go away and I was thinking like no because it's made very little money and I just put it into my own limited company from work wise so it's kind of linked with everything that I'm earning from the practice and I'm like it's so that was a real dark day I think what the hell do I do here so he recommended a German patent lawyer as long as you go to court in Germany and like find all this stuff and so it turns out there's a device it's they had a patent in Germany it's similar but it's not quite and it's but it never went to markets it never existed never went to market it was just had this patent for kind of seven eight years ago so the patent the gym pattern was very very good actually he was like don't worry about it and then he then countersued as the laws do of well actually your patent should be granted because of XYZ and it's very different in these reasons and actually we will counter so if you take this any further or we would settle so it turns that they kind of wanted a payment for it and it wanted like a royalty and it's just kind of looming on my head the whole time then I kind of then stopped because I've had this another country that I don't know about and stuff so in the end it is they wanted a yearly fee and then the distributor in Germany was like well actually it's you know it only sells a bit I if you don't industry in Germany it's fine it's not worth the royalty for their arsons I kind of said that we're happy to do it as a percentage and never really have back them in an in an in an in an fizzled arrow but that point in that mean realize how lucky we are to do something like dentistry because there's no indemnity to cover that you know and while we've it was the worst it can have when your patient so is whatever and you make you realise that actually then you've got indemnity got cover you've got insurance so that was well well well I mean there is product liability insurance yeah so someone someone uses an enlightened product and dies yeah we've got insurance for that but season to assist the way that works is from the moment of receiving that letter any further sales they're they're they're taking royalties on if you don't say something do something yeah so you know you could have just stopped there and then and not paid them a penny yeah but that was I don't you know how much money do you put into it and because patenting itself is quite a good world wide but well it's still a still all pending this has started three four years ago and it's still all pending so patent fees initially probably back to the UK back 10k and a worldwide it's probably going to work out about five around the country so it's almost you've got to just limits what you do and I'm even at the point now where I'm like do I even take it because every month I'll get or two three months I get a invoice on the patent or you need to pay this and pay that so I think it's made the profit wise hasn't made it you know huge amount because the the fees are ongoing but I've already had a Chinese dish you'd make it make a copy to the approach to O.C. and said we were doing this and it's based in my product and actually even used the pick the clinic a picture that I've used in in that email so for me I just see that well as a compliment they thought it was good enough to actually copy themselves and so I kind of sent that to my lawyer he's like oh be three and a half thousand send a season to cis letter to them I'm like you know I can't be bothered like you know I'm not doing this with the money I'm doing it because it helped out and occasionally you get the name gets recognized that a comment was oh I use it like and you know and I see it on a Facebook post sometimes someone's like I've been using these are amazing they really helped with these cases so for me that's it that was lovely that was kind of my leaving my stamp and it's like a small sort of got you do you do this yeah it's a little button and has a little offset where you put the wire on so basically you're using the full activation of your of your night-eye wires so a night-eye wire the way teeth move is especially the start of the alignment the night-eye has shake memory so we want to bring it back into that position so you're activating that wire to bring it back so where the wire is actually ligated it's about half a centimeter above where you've put the brackets one of the arm kind of on exactly on a lever arm and so well the first a few cases I'd patient come back in and booked in as an emergency and I'm there obviously cracking myself and they come back in because it's like oh the tutorial down like it was literally bringing down within like 10 days or two weeks and the most golden moments those things yeah those times when the stuff like that happens that if it back to individual patients we tried stuff for yeah for me would have been friends and family yeah yeah yeah yeah yeah yeah yeah yeah yeah yeah yeah and you think wow I'm on to something yeah yeah yeah yeah and but you're right totally different to commercializing yeah absolutely totally different yeah I mean I'd say the ideas were like five percent of the problem you know like and patenting such a pain in the arm like we've done things like not published research so that our competitors can't read what we've discovered yeah yeah yeah and then you get dentists saying where's the research yeah yeah I mean we've done some research but we haven't published it yeah they don't believe that yeah yeah yeah and and when you break it to dentists sometimes that the research is for marketing purposes yeah rather than for learning purposes you know that becomes it's like a really weird thing yeah because but dentists have been trained you know you said you said I'm skeptical yeah and you should be yeah should be yeah because you know us companies are trying to sell you stuff yeah then there's been trained to say where's the study yeah yeah and then companies know that so there's a bunch of studies from marketing purposes they've done they don't understand sometimes often when you go to institutions to get studies then the guy will do it seven different ways and and then you'll publish the one that suited suited your your purpose best but for us the study has always been to find out the answer to a question and once I found out the answer to that question I don't want to tell the world the answer to that question yeah they could take me thousands of pounds and effort to get the answer to that question yeah that's for me yeah it's a funny thing isn't it is and it's yeah and I suppose it's and in the people say what's your next idea I'm not an idea it's just a flicker is I came across I was a clinical problem that I had and and it helped me and even if you have one good idea in your lifetime it's brilliant right yeah you've moved the conversation forward by one good idea yeah yeah yeah absolutely and yeah you get something oh I do it different I was fine don't care you know you there's different ways to do things and it's there's some people I like it and some people love it and that's absolutely fine others that think it's and that's and that's what you're going to get because you're going to get those skeptics and then and I think also with with author we've there's been a lot of stuff you know the whole when Damon was first out that it can treat everything non-extraction and it can improve airways and it can do all these things it can grow bone and I think where orthodox has had almost its fingers burn from that of well you know it's just a bracket you know fast-paced it's just a bracket it's all about the the clinician the plan you know the the classic thing is the tooth doesn't know what's on it doesn't know it's got a Damon bracket on it doesn't know it's got an Amazon attachment on it it's just how you deliver that and so where all these claims are coming in and now the whole airway thing is a big thing and when orthodox weather we actually help airways or not and so it's I'm skeptical and like I said you should be skeptical but when sometimes orthodox comes to me go well this because this because it moves at play it's like it does all it's doing is just bringing the tooth down so you can put the bracket in the right place then you can do the rest of the movement like I'm not reinventing the wheel and I'll probably going to intrude the other teeth I said intrusion is one of the hardest movements to do in orthodox so you think that this thinking is going to intrude all the other teeth and not extrude this can which wants to erupt in the first place so yeah but anyway I was like well did you know it's there if you want to use it and if not then absolutely fine you know I'm not I don't need you to do it you know it's not for money it's not for retiring it's just there it helps you great if it doesn't move on before this what would you have to do yeah I keep on changing the position of the yeah so I put a bracket on I tried all sorts of things I put bracket on and put the wire above the bracket to get an extra little bit of activation and then it comes down a bit and then next time reposition doing the same thing against highly higher up the problem is you put in the heart the bracket as gingival as you can so it comes down but because it's the bracket so gingival the all hygiene hasn't been great even the tooth's come down
and the gingerive hasn't moved because the ginger is inflamed. - Oh, no. - So then you end up putting like bends in an eye-tight wire or trying to do different things and all sorts of stuff and I thought it's gotta be an easy way. I just literally need the wire to go up there. So some would, you know, you go to America and I go, oh no, I just cut the gum away and put a bracket on it. - No. - Well, you could do that, but I don't wanna know what my patients are necessarily. So yeah, so it was kind of that. I was like, there's got to be an easy way to do this. And I just woke up one morning, I'm like, I think I've got an idea. I was drawing to work and I was like, I call my mate who's a lab tech at Guy's, Nick who's a fantastic guy. And I was like, can you make me a couple of these prototypes? This is what I'm planning on doing because yeah, sure comes up. So I went to Guy's for a bit, catch a quarter, but then we went five or six of them, tried it on a couple of patients. And yeah, it just worked. And the first one, I actually come back in two weeks later within emergency, and the emergency was the wire sticking out the back because it's brought me down so quickly, the watch that what, yeah. So I was like, okay, well, this works as a good problem. And so then I kind of document through your cases and that kind of grew from there. But luckily, it's not going to move the need on an ortho-exit there to help people out if they want to. But it's kind of that I've done something quite nice and to get recognised every now and again. It's very lovely for that. I'm sorry. Yeah. If someone wants to look at your programme, where can they go? Just on the website, it's online-orthonto-academy.co.uk. We've got an Instagram page online-ortho. Online-ortho-academy is the tag. But yeah, on that, or on my Facebook, they have, I'm more than happy with the contact me, message me, DM me, like I said, it's a person. So they can just say, well, I don't find that information. They can just drop me a message on Facebook and Instagram whatever, and I'm more than happy to kind of talk them, talk them through it. Amazing. I've enjoyed this one. Yeah, I enjoyed it. I've enjoyed it. I've enjoyed it. Final questions. What comes to mind if I say your favourite education, like your favourite lecture or lecture role or course? I think it's different with orthotics compared to general dentistry, because we do a lot of our learning through our M-orth programme. But I remember the first time I went to the American conference, which was huge. That blew my mind. So for example, Willie Diane talking about invisalign and some of the stuff they did in invisalign. But then all the big names are there. All the people that used when you were studying and all those evenings with those papers they'd written, they were all there, McNamara, Prophet, Lara Johnson, and all that stuff. So it's just going up to it. And they're all under the one roof, and they're all talking about these different things. It's fantastic. Anything that Lara Johnson does, I absolutely love. He's a American author who has got a great affinity for British 70 sports cars. So he's just one of those eccentric Americans. And he's very, very pragmatic about it. So actually in America, we talk about, they do a lot of early treatments, and maybe we should do some more of that in the UK. But it takes it too far. And the studies show actually, you lose 80% of the expansion that you gain at that time. So how much they were doing? And one of his famous quotes were early treatments is a practice management decision, not a patient management decision. So the fact he's in that field in America, he's very, very pragmatic. And kind of how I feel like I have similar views to him. So anything that he does, he's kind of going less on the lecture scene now, and you know, profit bill profit, anything that he did was fantastic. So we had these big names in orthotics who wrote the books on that. So, but it was never about courses for them. It was all about speaking at conferences. I go into these big-- How'd you stay on top of what's going on in orthotics? Conferences, I mean, I just got back from Rio, which was a world conference. So it's an excuse to travel. I like going into the American conferences a lot. They do it in quite big areas. They always have a big name or a big event that goes with it. So you know, it's a kind of touch with that. European conferences and flicking through the journals are every now and again. But there's also a thing. I don't know if this is me being skeptical, but I feel like someone's just-- there's much new stuff. It's just reinventing the wheel or the skeptic-emegal. I've got my way of doing it. And it works. And until I see something that's being used different times and makes sense to me-- because orthotics is really-- it's biomechanics. If the biomechanics work, it works. So it's quite-- I'm quite a logical person. I can kind of visualize or see. Yeah. It's such a profitable area in a business line that what happened with a business line that I can imagine massive resource going into it. The way business works out is someone sits in front of an investor and says, "Invigilise worth more than every other dental company put together. So let me 100 million to make the next invigilise." And whatever that thing is, your area is going to be flooded with AI kind of stuff. Absolutely. It is. You take the valuation of a line at the word AI. There are 100 companies raising cash based on that. And even dental monitoring, including AI. Yeah, yeah, yeah. So what I'm saying is, yeah, yeah, yeah. I know what you're saying about, you know, it's biomechanics. But your area is going to have a lot of innovation in it, a lot. I'm sure of it. Of course, you've got to be skeptical, right, to start with. At the same time, you know, I feel like ortho is going to change a lot to-- I think it's an exciting time. Yeah, it's exciting. I think the biggest hurdle and biggest thing where we've got over is patients come and out. They want ortho. Kids, we talk about kids now. They come in and they're like, you know, you tell them you don't need to raise their start crying. Well, 20 years ago, you told them we need to raise their start crying. So it's the fact that it's just become enormous, become a writer passage now, which is, I think, it's fantastic because the benefits are there. You know, you look at the research and actually, well, if you're very good at cleaning your teeth and you've got crooked teeth, then it doesn't matter. You don't need ortho. But the research doesn't necessarily show it. But what we see on a day-to-day basis were patients value their teeth more. They clean the teeth better after they've had their treatment. Those great studies actually that was done, profiting Newton in Kings was very much involved in the kind of the psychology-- it does not psychological stuff. And I think it was a study where they looked at it. They photoshopped eight-year-old teeth. And they got the teacher to judge how clever they are on just the photo of their teeth. And you've had a big overjet that teachers thought you weren't clever and you weren't going to do succeeding lives. So if you'll be judged at that age-- Class three. Yeah, purely-- A bit class three gets-- Yeah, a lot of-- Yeah, a big, big, big, big, buck teeth overjets. Yeah, a class you got kind of looked at. Yeah, it's just sort of-- it's amazing how you just missed judge someone completely on their teeth the age of eight. What pisses you off about ortho, like about the current state of the market, the dentistry itself? I think-- what annoys me-- I think when some orthodontists who are high upon their perch and think what I do is amazing and what they do and all these things that they do. And I think when you go to the-- what annoys me, you go to these conferences and you-- these people are showing these things that they're doing with tads and marpie, which is taz-assisted expansion. All the stuff and all these tads everywhere. And I can do that by just taking out an upper left five. So you think, OK, is it worth going through all that? And I work in Tom Rajwals. You know, you apply, went to those Tom Rajal's mums and said, well, I'm going to put these screws in here and do all that. They're not going to want that for their little kid. So it's not real world orthodontics. And what annoys me-- actually, the lecture I just got back from Rio, very prominent orthodontists did some fantastic stuff years ago. Now has come back and showing all the complications that occurred. And you just think, well, why were you not doing that before? You could show the complications. You show those 10 cases that work really well. You don't show the-- now, one is a big name. You can then come out and go, actually, these are the complications. And some of the stuff they did where they did-- they did two tads in the palette, and I thought, you try and split the maxilet to try and get surgical expansion without surgery. You then show cases where you've had complete asymmetric expansions where they've got the jaw on one side, maxilet is expanded on one side and not on the other. And then massively asymmetric. Get one. CSF brain leak. How does CSF coming out of there knows? Because it split it at the cranial base. Jesus Christ. And I'm thinking, but you've gone and lectured all about all over the world about doing all these tads and doing all these things. And then that annoys me. I want to go to these lectures. And I want to say, yes, the five cases that you've done well. But I want to say the 10 cases that went badly. And how you manage those cases. The nature of the thing is when you first start doing it, you've got to show that you haven't got the failures. That's the thing. But then you'll be doing it. But then we'll never progress. We'll never progress. Yeah. No, true. And that's why I'm always a bit skeptical about it. And a little bit risk averse when it comes down to that. And I think, actually, if it was me, do I want that? And actually, I'd rather refer to someone else to do that. And then-- So then there's the risk of being called the dinosaur, because you don't do any of that stuff. But I'm quite happy to keep my-- like I said, I see my patients as a bit real. Keep real. Yeah. But that's something that you should show. Yeah, so I mean, at dinner day, there are enough patients out there just to be doing good box-dandered orthodontics. You don't need to be doing all that stuff and trying to avoid having surgery. And then they'll all just go back to all of them, just end up having surgery instead. And that's why the patients would want it. And that's absolutely fine. Do you think that was a banker who discovered. Aligning in Visaline. - Yeah, MIT II, MIT grads, wasn't it? - No, it wasn't a dentist. And I think the story goes that he retainers had a one for a while in the teeth move, tried to shove his retainers back in and realized he can move the teeth back. - Yeah, yeah. - Like a massive breakthrough, a massive breakthrough. A huge massive breakthrough. That you could sit there and say, well, in a brace of working fine, why do we need these? - Yeah, but I think what it is is the adults. Brace work for really fine, but the big stigma, if you are well off in your 40s or what's stopping you how getting it he straightened. It's, it's, it's have wearing a metal brace or wearing a brace. And that's why back in the-- - I mean, I was part of that poor slidding for the-- - Exactly. - That was the option. - Wasn't it good to choices? - Yeah, exactly. In Visaline has done great for that. - Yeah. - And I think that's what it needed. You know, there's an element of lingual, but you know, that's a whole, whole story. - Have you ever done that? - Done a few lingual cases. I, I try and put patients off now. So they've got to twist my hand to be able to do it. I charge almost twice as much as normal because it is twice as hard. - Yeah. - It's, it's, it has its places, but I tell patients you're gonna hate me for a week. It's gonna be horrible. It's twice the price. - It's comfortable, it's comfortable. - It's comfortable, it's just sits on the tongue. And, and the case I've done it, it worked well and it's not, and actually I've got 100% record and I'll just retire at that. So, unless there's a, but now any of the complicated cases where you can't do with patient once in Visaline or something, it's discreet. Those kind of patients, I probably don't wanna do with lingual either. So I'd rather do with the liners and, and just consent, actually we can do the rest with hybrids mechanics with fix or power arms or extra things we can do to kind of get around. So I do extraction cases with, with the liners, knowing which extraction cases work. And it consenting like it worst cases, a few months at the end instead of the whole 80 months worth of things and, and a single large might be instead of whole dual large. So, I think there are ways rounder and, and ultimately, you know, it's, this is the plan that I'm comfortable doing and happy to do. If you wanna go over that with me then great. And if I'm sure you wanna find someone who's gonna do thousands of all sorts of promising to you then you're more than welcome to go, and to go to them. So, I just try to keep it very realistic. I don't try and overdo things. I think when you get pushed into maybe trying to do something that's a non-extraction and then the recession starts happening and you go, well, at that point then, well, you know, what, what, what do you do that aspect of it? I don't like the extraction, the big non-extraction. So I think my extraction is probably about 25%, 30%. Which I think is probably about average. And I thought I don't agree with everyone does everything extractions, I don't agree with everyone does everything non-extraction. I think it's, and I don't agree with everything. There are some, talking about earlier that, there are some that then sort of just only do aligners and, you know, and only do metal fix braces. I think it's nice to have a variety that you just treat what is best for the patient and just go through those options with the patient. I feel like I'm very good at explaining to a lay person how teeth move and what, what works. And that's that consultation process for me. It's not a consultation, it's a chat of what I can do and improve and make sure on the same page of what we're trying to achieve. And to see whether I can help them or not, because I want every patient to be happy there in a bit because that's where I get most of my, and referrals from is that result, but it takes time to get there. Saying only about the private practice, it will take time to build up because you're not gonna see results of 80 months down the line. So you're gonna have 80 months to years of starting cases before you get in that word amount through referral. Yes, eventually it will come to fruition, but it's just doing a good job and just being nice to people and nice people hang out with other nice people. I just think it's just the easiest way to grow a business. And the money will come. You don't need to chase it. You just do a good job. We treat everyone as if they are siblings, or your daughter or whatever. And yeah, it will come. And the success comes from that. And I think that's how I live my life. That's how I wanna do. I have to have a good night's sleep. I'm, my part of the reason I'm always doing something because my brain goes into overdrive. So I'm always thinking about that patient and thinking about that. So if I'm in a position where I don't have to worry about those patients, I can sleep easier. And I, final question. The fantasy dinner party. Yeah, three years, dead or alive. And, right, so probably Edward Angle, who's kind of the godfather of the orthodox, so the fact that he kind of started all that back in the late 1800s. I think it's amazing that someone can create a whole field which doesn't really exist in there. It's still weird. What do you think about it? It's still weird that it's possible to move to. Oh, absolutely. The distances that you can move. Yeah, it's not like you see those time lapse things. Yeah. Jesus Christ, man. I'm quite in love with that. And it was him, right? Yeah. And back then, I think it took a day to fit a brace. It was all gold and different bends and all sorts. And it was half a day to adjust the brace. So, to kind of, but also then take that idea that you're going to put all this on a patient and then start having the belief that you're going to be able to move those teeth. I think it is amazing. Another one, probably said before, but Steve Jobs, I was quite a very big Apple fanboy at uni. I was probably going to the first kind of white clamshell, Macbooks, and his presentation style. So I'm one of the first couple lectures I did. At dental school, I won the presentation prize for our elective, but I tried to do it as a Steve Jobs presentation. You know, that black and blue gradient background with white writing. I really kind of, you know, in the way he's just, it's just, he's someone's got these lectures and it's just words, words, words. And he just thinks, oh, what are you doing? And it's that has to really kind of learn how he presents things and how he makes you think of, you know, that he has, it's the why not the how isn't it? It's sort of why do we do these things? And so, yeah, I had one of the first, you know, I think I had the second generation iPhone back then when the first kind of came out. Now I've moved away from it and partly because it's, it's not him anymore, but it's him, I think, I think absolutely on a pedestal. And then I was, I'm in an eye between sort of Robin Williams, he's just, I just wrote watching his movies, or Tiger Woods. And my wife is like, you can't say Tiger Woods because he, because he cheated on his wife. So you've got to say, Robin Williams, one really is a much bigger part of the much more important person than Tiger Woods. Kind of grew up watching his movies in the 90s and yeah, it was getting actually just those movies watching as I remember as a kid with my family, you know, first moving to the country, you know, his, you miss his dad, but I was the first one that I remember and just kind of grew up on and just, yeah, an absolute legend, absolute hero. But also the way he went and all that. It's sad and interesting to talk about. Yeah, and it's sad that you think he was depressed, you know, someone, and he has stories what he's, I can't, one of the actors was in hospital, I think, just recently, and then he turns up as a nurse and pretends to give him a, I can't remember the actor was, but he came in and you know, just made them, just got diagnosed as cancer and Robin Williams comes in and dresses up as a nurse pretending to give him a, and they know, they know, exam were a sponge, but I thought it was, but yeah, it's kind of stuff like that, you think, what, what, what, and sad that he was, he had, because we never saw that side of it, but it's quite common amongst comedians apparently. Yeah. How would you like to be remembered? I think just as a good clinician, I think I've always wanted to do the best and what I've done, I've always wanted to, do the best with my patients, I think I've always wanted to, even the academy I wanna make it as, you know, it's not about the money, it's about providing service and getting to know people and helping people. I think it's all about helping people, I think. You know, we help patients with their teeth, help dentists do ortho, help orthantes, bring a partially rough decay nighting down, you know, for me, I just think, and I think that gives you more joy than anything else, well for me in particular. But that's pretty selfish because when I feel like when I help people, it makes me happier. So that's how I kind of get my dopamine hit. So yeah, I think just a good clinician, good husband, good dad, good golfer, just being good at what I do. Would you want your kids to become dentists or the dentists? Like, is it something that you'd encourage? - I don't know. I think orthontists, yes. I think that it's really hard to know what dentistry's gonna be like in, you know, 10, 15, 20 years time. - I don't know what anything's gonna be like. - No, I know. (laughing) And all my family, I come from family of doctors and none of them want their kids to be doctors. I think that's a shame what life in any NHS is like. - Definitely not in the UK. - No, no. - My brothers are doctors. Not in the UK. But other places where you might say, "You're right, go ahead and become a doctor." - Yeah, yeah. So I probably wouldn't push them. - But dentistry. - I wouldn't push them, but I think, yeah. - I think it's just so difficult. I think coming out now and trying to be, you know, I think if you're like, now. - Everything's difficult, though, though. Everything worthwhile is difficult. - Yeah, yeah. - I think it's because there's no structure you come out and you just saw the social media dentists showing all these stuff and you're thinking, well, if you're not good at social media, what, how, you know, how can you put yourself out there? I think the other one with dentistry is what. I think it's gone other days of a box-dunder general family and an interest dentist. I think now you have to find an niche, whether you're a businessman and a practice owner, whether you specialize in orthotics, whether you do cosmetic stuff, whether you do implants. I think, or in a super associate, we do everything. I think the gone other days are just a box-dunder family and an interest dentist. I think that's, that's, that's, I probably wouldn't actively discourage it, but I wouldn't encourage it. I think you've got to do what you love. And I was like, - Tell them, no, will they love it? - No, I know, it's difficult. - You said you were kids 13. - 13, my son, yeah. Daughter's nine. So, you might be, you might do, yeah, I'd my son one day turned up and said, I want to do aerospace engineering. - Brilliant. - I was all right, you know, thanks for gonna do that. - What are you doing? But mostly, yeah, I think we're really lucky though in this country because I think when I was growing up my parents are like medicine Benz, I think in this country where you are, whatever you do Because I play golf and quite an exclusive club and sorry and you see those other people then and there's only two three densities There's no doctors But they've done they've crafted a field in something that they love doing and I think whatever you love doing you will make a success of it No matter. I know they don't know what they love. I don't it's easy saying that isn't it It's you know that club of yours. That's a selected group of winners. Yeah, it's like It's not real But I mean, yeah, I think they've got to find their own their own thing and I was just lucky That was kind of pushed into a back shift worked. I really really enjoy it He my son's quite similar to me. So I see a lot of myself in him. So what do you wish you were more like? and I sometimes I'm not very good at Okay, so the classic example is I feel like I'm a very good clinician and I feel like I'm doing a good job They can't even feel like Dunwell with the eruptor. I'm not very good at being one of those social media people has a hundred thousand followers and say look why do I I'm not very good at that. I'm not looking very good at putting myself out there. I'd quite like to be like that and but Yeah, so maybe maybe that but then it's just not me. It's not you know I'll go out someone comes up to me and go well I use your rock. I really like it as a person me shouting out telling people about it so I think Yeah, you wish you were a bit more sales Yeah, because what is I actually I actually actually really enjoy the sales of density so the concentration of the patient I really enjoy and it's not about being sales It's just about believing in the product that you're doing which is orthotics and and just being honest with them and and I get that buzz When a patient goes ahead from a consultation and it's not about the money It's it's actually now about the trust that they're trusting me with their teeth or with the kids teeth And it's that that I still get the buzz from You know, you know the difference between sales and branding No, I don't So I'm once kind of a push ones a pull in so much as There's you know you're not getting someone coming up to you saying buy these Nike trainers Yeah, you know that it's not a sales but all here they are on discount. Yeah, you're going to them You've been pulled this all up or whatever it is That this all two sides of the same coin, but very different. I've found over the years I might might sort of appetite for sales has gone down There was a time where I used to like it, you know like you know striking the deal. Yeah, speak into that Yeah, but my app for branding has gone up. Yeah, but you know what we stand for you know these sort of efforts. Yeah But I'd say you're quite good at it dude. You know, I think you're scripting yourself I don't know it like you don't want to be good at it. What do you mean? You're not bad at putting yourself out and saying saying it how it is because you're kind of honest You know that and honestly goes a long way and it is like sales as a dirty word in a way But actually the best salesman end up being your friends and yeah, you know like the guy who was sitting here when you walked in Yeah, he's been selling to me for 20 years. Yeah We ended up having a conversation for like 45 minutes of our conversations about nothing to do with what he was gonna And then he said well, let me tell you what I'm just saying, you know, I like seeing him. He's a good friend Yeah, so it doesn't have to be a dirty thing. It's funny. It's because I don't see that sales You know it's sales I think because sales has got that it's just good things. Yeah, it's a different thing good sales about it Yeah, which is supposed to be the bit that what you say about the branding and the pulling and sort of You know like I mean author doesn't but you know like some people have cosmetic filler and stuff and you can tell and then some people have it and you can't tell yeah, yeah, yeah Now you could say oh, I hate those big lips. Yeah, yeah, cuz I can see that then but the the fact is you can't tell when it's done well Yeah, yeah, yeah, yeah, yeah, true It's a bit like that. Yeah, a bit like that. Yeah, it's been a massive pleasure, man. Thanks a lot for coming. Thank you. I'm really enjoyed it This is dental leaders The podcast where you get to go one-on-one with emerging leaders in Dentist Street Your hosts Payman Langrudy and Prav Salankay Thanks for listening guys if you got this fire you must have listened to the whole thing and just a huge Thank you both from me and pay for actually sticking through and listening to what we've had to say and what our guest has had to say because I'm assuming you got some value out of it if you did get some value out of it Think about subscribing and if you would share this with a friend who you think might get some value out of it too Thank you so so so much for listening. Thanks, and don't forget six star rating
Podcast Summary
Key Points:
Effective orthodontics relies heavily on patient communication, trust-building, and honesty about treatment possibilities and limitations.
Building personal, long-term relationships with patients over frequent appointments is both a rewarding and challenging aspect of the profession.
The practitioner discusses balancing NHS and private practice, preferring a system where treatment decisions are not financially pressured, allowing for ethical work.
Orthodontics has significant emotional and psychological impacts, improving patients' self-care and dental hygiene, and is often driven by parental investment in children's appearance.
The field is viewed as a viable business, particularly for private pediatric orthodontics, but the dentist values clinical complexity and patient outcomes over purely commercial motives.
Summary:
The transcription is from a podcast interview with orthodontist Zayed Esmail. He emphasizes that the foundation of successful orthodontics is excellent communication and building trust, especially during the initial consultation, by being transparent about achievable outcomes. He highlights the unique, close relationships formed with patients due to frequent appointments over years, which is personally fulfilling though sometimes bittersweet when treatment ends.
The discussion covers his practice within a Bupa framework, where he maintains a distinct brand identity. A significant portion focuses on the ethical dynamics between NHS and private care; he prefers a model where he can present all options without financial pressure to "sell" treatment, ensuring he can practice ethically. He notes orthodontics often improves patients' overall dental hygiene and self-esteem.
While acknowledging private orthodontics, especially for children, can be a strong business driven by parental concern for aesthetics, he is motivated more by treating complex cases and achieving good results than by commercial factors alone. The conversation concludes with his personal background and path into dentistry and orthodontics.
FAQs
A great orthodontist excels in communication, builds trust from the initial appointment by being honest about achievable outcomes, and develops personable, long-term relationships with patients, seeing them almost as friends throughout their treatment.
Trust is built through clear communication, honesty about treatment possibilities and limitations, and by proactively addressing risks from the start, which shows patients you are transparent and not misleading them.
Private treatment often offers more options like Invisalign or ceramic braces, more frequent adjustment appointments, and access to early treatments not typically funded by the NHS, while NHS provides essential care for qualifying patients, sometimes with longer intervals between visits.
By offering both NHS and private options ethically, allowing patients to choose without pressure, and focusing on doing good work rather than financial targets, which ensures professional satisfaction and ethical practice.
Orthodontists often form close bonds with patients, especially children, seeing them regularly over years, which can lead to treating entire families, but it can also be bittersweet when the relationship ends after treatment completion.
The NHS rarely funds early treatment except for specific cases like anterior crossbites, while private systems may offer it more broadly, though there is a risk of overtreatment in some private settings to capture patients early.
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