Quality Dentistry Doesn't Scale: Christian Coachman On The Michelin-Star Mindset.

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Quality dentistry is not scalable. There's a gold standard. Are you in dentistry trying to find a way to make more money? Or are you in dentistry trying to find a way to be a better dentist? And they don't coincide.
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Okay, Christian, welcome to the Contact Point Podcast. How are you doing? Very good. Great to be here. It's wonderful to have you here on the hottest June day on record in London, I think. London, in Europe, in the planet, I think. Yeah, it's a hot one. It's a hot one. So, Christian, I wanted to start...
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going backwards before we start going forwards and um we had a lovely dinner last night and we were we were talking about uh the first time we met which was in luxembourg of all places the the one and only time that i went to luxembourg um and we met at um a dsd event uh with some amazing people in a beautiful place and um for me it was
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very early on in my career. I think I've been qualified for one or two years. I'd obviously seen everything that you guys had been talking about in terms of DSD. Obviously at that point, very, very different world to where we are today. So I wanted to start off with your thoughts on how you think dentistry has changed in the last 13 years since then. How is it a different world to where we were back then? Of course, that at that time,
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It was all about convincing people to embrace technology. Now it's trying to convince people that it's not about, it's not all about technology. Um,
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It's like in human history, you know, you have these peaks, you know, you go to the extremes as new exciting things show up and then it takes some time to find the balance. So from not seeing the reason to use technology
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to using too much technology and thinking that technology is everything. We are now trying to find the balance and balance everything.
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technology with human skills and what I call become the exceptional dentist or the ideal dentist by balancing this. So we are on this journey to try to find a balance. So what does the ideal dentist look like then? Let's get straight into that. For me, the ideal dentist is the dentist that asks
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themselves the important question of what type of dentist you want to be. Do you want to become the three-star Michelin dentist, yes or no? Do you want to do dentistry to make more money, or do you want to do dentistry to do better dentistry?
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This is an important decision. And of course, you know, you have the cliche, blah, blah, blah, that if you, if you are a better dentist, money is the consequence. And there's a lot of BS around this. You know, it's, it's a clear cut for me. Are you in dentistry trying to find a way to make more money? Or are you in dentistry trying to find a way to be a better dentist?
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And they don't coincide. It's easier to make more money in dentistry being an average dentist. It's easier to make more money in dentistry by studying business topics.
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but as we know, we only have 24 hours in our day and we only have one life. And I don't judge. It's just a decision. Do you want to invest on becoming the best possible dentist you can, like a three-star Michelin chef?
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or the level of dentistry that you are delivering is enough for you. And now you want to scale or you want to multiply or you want to amplify or you want to delegate or you want to grow and you want to increase profit and you want to learn marketing and you want to increase lead generation and you want to have more patience and make more money. Mm-hmm.
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it's all about your focus. And for many years, I was trying to understand how to help dentists grow financially. And now I am in the opposite direction on asking myself how to help dentists become the best possible dentist they can become, regardless of the money.
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Because, of course, if you become an exceptional dentist, dentistry is generous enough to give you a great life. But probably not the private jet life. Right? The Instagram life. So, yeah, that's the choice. You need to ask yourself what you want. And I'm more and more in love with the idea of trying to become...
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the best healthcare provider that we can become. I've got so many different directions my mind's moving in. It's really interesting. I mean, I guess the question is, if we're going to double down on that three Michelin-starred chef analogy, the natural place that my mind goes, maybe because I imbibe too much business information, but it's to someone like a Ramsey, who obviously...
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got to that level of pure excellence and then commercialized it. Yes. But obviously is now no longer delivering the care or the actual, he's not at the pass anymore. That's it. How does that fit into dentistry? Do you think that's the, that's why I love this analogy and I always use it because the restaurant industry has all the examples. And again,
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I'm not here to judge. I'm not here to say what is best. It's a personal decision, option. I do admire very much dentists that became amazing business people, entrepreneurs, and are finding ethical ways to make a lot of money. It's just not my essence, I realize. Yes.
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you know it's the artist in you that's why that that's probably that you know i i went on that direction and now i'm moving backwards and i'm realizing that that's where i find my excitement on the on the details that makes you move from great to even greater from great to exceptional so i'm not talking about average to good
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You mentioned Ramsey, you know, he was amazing. He got to the top and at one point he made a decision, you know, let's leverage all of this. But I can guarantee that at that moment, he had another option. I'm already among the best.
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How can I become even better? Right? And then you need to choose because you need to invest on yourself in different ways.
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So dentistry is pretty much the same. I like to say, and people think it's a little controversial, but I strongly, and the more I study this, the more I see the examples in real life, the more I believe that quality dentistry is not scalable. There's a gold standard. And every moment when you become a very good dentist with a very good reputation, you start to have these
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crossroad, intersections that you need to make decisions. And every decision is, I can become personally slightly even better or I can make more money.
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Yeah. Yeah, it's fascinating. Miguel Stanley said exactly the same thing to me many years ago. He said, you either have to be in your place, just leveling up, leveling up, or you have to, if you want to scale, that's a different mindset altogether, right? And people get angry sometimes with me when I say that, and they say, no, but we can scale with quality. I said, of course. I'm not saying you cannot scale with quality. I'm saying that if you don't scale,
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you can deliver even more quality. Yeah, yeah, yeah. Right? That's a choice. That's the truth. I'm not saying that scaling is unethical. I'm saying that if you don't scale, you find your gold standard, right?
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So at one point, every very good dentist gets to that level where they are 10, 15 years into their profession. They have the artistry. They have the science. They have now the experience. Clients are coming because they built their reputation, you know, after 10, 15 years. Basically exactly where I am in my career right now. People are coming, you know. You have the perfect – the team is at its peak. It's getting better and better. Yeah.
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You start to have more patients that you can handle. Agenda is booked. You start to have that temptation. Should I grow maybe one or two more chairs? You have those two, three younger associates that are top, that is the perfect combination with you, that you can still be the quarterback of the whole process.
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the hygienist that works with you for 10 years, and the hygienist has an amazing team, but it's small, but it's performing at its peak. Everything is working very, very well. You always see a little bit of room for improvement. As soon as you say, you know what, we're going to scale a little bit,
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is you give up on making that gold standard slightly even better. Yeah. Right? So the moment that instead of two, three associates, you have six, seven, instead of, and I'm guessing what is the gold standard, right? I have my idea of what is the gold standard because I've been seeing a lot of dentists and I see exactly their journey, their career, and the moment that they start making more money but the quality...
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It can still get better, but it could be even better. And I see that, this connection. More money, not necessarily more quality. More money means better marketing, means better sensation that there is better quality. More money, more marketing, more experience, more expertise on hospitality,
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And more sensation that the dentistry quality is also better, but it's not. From the patient's point of view. So the patient has the sensation, right? But actually, you know that the dentist, and I know this as a technician, right? So I'm on the back. You see it from the other side. I see the little details, you know? Yeah.
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And I see the few dentists that were courageous enough to not fall into that temptation and say, I'm going to stay like this. And month after month, year after year, I'm going to become slightly better, right? As best as I can.
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That's the three-star Michelin chef mentality. He's happy to stay at the pass, just refining his craft. It's a decision, isn't it? I think what I see in dentistry a lot is people not actually giving themselves the time to even be aware of the decisions that they're making. One of my favorite quotes is, no wind is favorable if you don't know to which port you're sailing from Seneca. And yeah,
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I think about that quote all the time because I see so many people floating in the ocean, letting the wind blow them in whatever direction. They see someone scaling and buying it. Oh, my friend's just bought another practice. I've only got one. Do I need to get three? Am I falling behind? There's so much like... That's why I started with the question, right? Yeah. You need to answer the question first. Yeah. Where do you want to be in five years? Yeah.
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Again, no judgment. All the options can be ethical. Unfortunately, sometimes I see options that are not that ethical. But you need to start with the question of what exactly you want to master. Do you want to master the process of scaling with ethical, decent quality? Yes.
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Or do you want to master the art of becoming the best version clinician that you can become? These are completely different paths. And as a restorative dentist, there's so much to improve. Even if you think you are an amazing restorative dentist, I...
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I can tell you there's so much that we can still improve to become even better. Of course, that our society pushes us towards numbers and growth and success has a definition that for me is not correct. That doesn't really...
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stimulate, encourage excellence. Our definition of success of capitalist Western society doesn't encourage excellence. It encourages excellence on the business side. Well, that's the quantifiable metric, right? Yeah. It's very difficult to give yourself quantifiable metrics of success in...
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incremental improvements in quality. You don't get the feedback. Do you know what I mean? You can't look at your bank account and see, oh, I feel good about myself. It's a humble personal journey. That's why... And as you say, the patient doesn't necessarily even see it. Many times the patient... But you always know you are on a three-star Michelin restaurant, even if you're not a food expert. You go to Tokyo and you go to these, you know, this unique,
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Sushi chef masters. Masters, yeah. Masters. And you know you are seeing mastery. Mm-hmm. And you know that that master is not necessarily worried about growing profit. Mm-hmm. And it's just... I was...
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I had that opportunity when I went to Tokyo once and they took me to a place like this. I was literally emotional with the experience. By looking at that person, that old chef dedication, life dedication. 40, 50 years. To that art. Mm-hmm.
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and just wanting to serve, to care, to improve, and to focus on details. And I know that he knew that I was not aware of all the details. I was appreciating the consequences of those details. I was getting the benefits of it.
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but not necessarily understanding the amount of days and nights and hours and dedication. The specific knife that he's using, the specific angle that he's cutting it at. But you know it's in there. I think it's just being in the presence of an artist. I think artist is the word, right? That's what it always comes back to. You don't need to be an expert in the field to understand...
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the dedication to have the level of expertise that it takes that length of time to get to. And I think for me, I I'm the same as you. I always, I always get, I get goosebumps when I'm listening to a really experienced sommelier. Tell me about all the different notes that go into a specific wine or, um,
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And Megan took me recently to Floris, which is the oldest perfumier in London. It's from like the 1700s or something. And we did this thing where you can create your own perfumes or aftershakes or whatever. And you pick all the individual notes. And the lady, Anna, who talked us through it, she had such a deep understanding of exactly the location from which each person.
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each smell came from. And it just made it such a more rich experience. And I think you can find that in any part of life. And this example, this lady you're mentioning, at one point in her career, she probably got to that situation that I'm very good at what I do. People love what I do. I'm succeeding with what I do.
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this decision, I can continue to be this artist and improve my own skills or I can kind of dumb down the process and create a methodology, create a business out of it and scale, right? This concept with cool, fancy marketing, pretending that it's still a boutique, unique, same me doing this artistry
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And that's exactly what we are talking. You have that decision moment.
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Yeah, I mean, it's actually another really great analogy because I could tell that she only wanted one thing and that was to create the best scent that was most appropriate for us. She wasn't trying to upsell me on the three-cent bundle. Exactly, but if she's really good, what is going to happen? One day she's going to be doing this to somebody
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that is a very, very smart business person. And that person will look at her work and will ask her, it happened with me, it will ask her, what is your business model? What is your exit strategy? Because you're special. What you're doing is very unique. But you can only do this for a few people per week, per month, per year. And you can only charge so much.
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Even if you become the most famous person in your area, in the world, you can only charge so much. And that's the moment that the temptation comes.
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Well, that's the Mexican fisherman story, isn't it? It's the it's the American businessman. You know this story? No. Oh, you don't know. It's one of my favorite stories. So it's a fable parable where I think I think I know. But it's the Mexican fisherman in Mexico just fishing away on the side of the of the bay.
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and the american businessman's there on holiday and he comes down and he says to the mexican fisherman uh look how many fish you're bringing you're doing a really good job here you should like build this up and scale it um and like you can get even more fish and then maybe you can um hire some more fishermen and then they can go out fishing for you and then you can get more boats and you can sell it and i can help you import it into america we can can up this tuna and we can sell it um and the mexican fisherman is like why and he's like
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Oh, so one day you can sell the business and then you can retire and then you can sit on the beach. Buy house at the beach. You can sit on the beach and fish all day. And he's like, that's what I'm already doing. Exactly, yeah. That's a beautiful story. That's exactly it. So how much do we need, right? And I just think more and more I'm appreciating the people that have this wisdom to make that decision and just stick with their art.
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And just do enough and be satisfied with just doing the best they can and not compromising in the name of the numbers and scaling and etc. Running a healthcare business like a dental practice is not simple. Different income models, complex regulations and real world pressures all alongside the day-to-day reality of managing a growing business.
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Find out more. Search Barclays Business Healthcare online. Terms and conditions apply. All lending is subject to application status and eligibility. Now back to the show. I think I think it's it's a question of being OK with internal metrics of success versus external metrics of success.
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And that requires like an ego dissolution. That means that you're not trying to keep up with the Joneses. You're not trying to get the next car, the next house, the bigger house, the jet, the helicopter, whatever it is, which I think is the antithesis of...
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the modern social media environment everyone is keeping up with the joneses on a global scale um and to actually take a step back and say actually that's not making me happy um that's not fulfilling me whereas when you use the reference of the japanese sushi master he takes great joy in delivering yeah what he knows to be the best quality that he can deliver not even comparing against anyone else just
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A love of the arse, I think, isn't it? And people are crazy about passive income. You need to find a way that your business is working for you, etc. So what? So for you to retire and do nothing? You know, what are you going to do? You're going to do what you love. So I want to have enough money to...
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So I work as a hobby and if I don't want to work, I don't need to. So that's the dream. But at the end is the story of the Mexican fisher. To do what? To do what you love? I do what I love. So why not...
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do it in the best way possible without this rush, without this need to reach numbers that will allow you, you know, because it's hard to grow a business, to build a business and you end up many times losing the joy of the journey. Yeah. So I don't have the answers. I'm just on this moment of
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reframing what I think is joy and happiness and success as a professional by after several years struggling in trying to learn how to run a business and because of the struggle to run a business, disconnecting with the essence of what I do the best. Mm-hmm.
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and losing a little bit my path in many ways. Right. And so I just wanna, I'm starting to ask myself, where can I become, how can I become the best version of myself? Is it as a businessman? I was not born to be a businessman.
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Actually, you know, I'm forcing myself into that position. I don't need to. So I need to rethink what I want to do the next 10 years. And I'm in this moment now. So have you got to do you have now your definition of success? For me, and this is very personal, that's why I don't generalize and I don't judge. I don't judge. Yeah.
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because I see artistry on making a good idea, become a good business, and scaling it. There's art in that. Absolutely, yeah. And if ethics comes first, if people come first, right? That's the problem. The problem is that when you focus on numbers, even if you're a very good person, there's a high chance you're gonna forget the people.
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And that's very, very few business people don't forget the people. Very few. And the ones that do, they are called naive or, right? The first moment a crisis hits, you shrink your company, you fire people, you have all the beautiful excuses. But you throw everybody under the bus to save your numbers. And then you give beautiful excuses to it.
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I'm not a socialist, but I think we need to find a balance. And at the end of the day, it's not numbers when you're 98 about to die. It's not the numbers that will make you happy. So everybody knows that. But we are stupid human beings, right? We are so stupid. And we make stupid mistakes. Yeah.
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And we know that that's not what matters. And we keep doing the same mistakes. Yep. Focusing on the wrong things. Just to prove something to somebody, I don't know. But we need to solve that internally. And then start focusing on what really matters. Again, I don't have the answers. I'm on this search.
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Yeah. But I think that's the important thing is the awareness of it. Starting to ask those questions. Asking the right questions. Yeah. I mean, you mentioned a lot of times there that there's a decision to be made. And I imagine you more than anyone is presented with many, many opportunities on a regular basis. Many great opportunities. Yeah.
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How do you make your own decisions as to which of those opportunities you take on board and move ahead with and which of them do you say no to? Because, I mean, I hear many very, very smart individuals saying that the power to say no is one of the most important tools in your armamentarium. How do you make that decision? Yeah, regardless if you want to master your artistry or scale.
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Say no is paramount. Learning how to say no, because that means focus. And as soon as you're doing something right, the problem becomes the excess, the excess of opportunities, right? People find you smart, and business people, investors, that's all they do, right? They have so much money that they don't know what to do with their money.
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So they need to constantly be finding opportunities. And they see people like you, like me, and they're like, these guys are very good. They have no clue how to do business. That's our opportunity. Let's promise them this and that with good intentions or not that good intentions. But they come because that's what they do. They spot the opportunities.
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And then you start to say yes to too many things, and then you lose focus because it's very tempting. And then you start to think about the numbers and the habitat and the exit and the multiples. And then you lost sight of your essence, right? Unless you make a conscious decision
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And you have a clear vision that your artistry is to transform your skills into a big business. And then you go, but very focused. So for me, I've been, you know, I had many offers to do many things to try to scale my ideas.
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None of them really worked the way I thought it would. I tried several different ways to scale. It didn't really happen the way I was expecting. And I'm starting to realize that this was a blessing.
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of the universe telling me that is not your path. Because if any of the business ideas work just enough for you to start making big numbers, that is very persuasive. Right? You start to interact in a different way.
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layer, you know, you start to meet different people. I'm talking about moving from being a very successful professional in dentistry like us, having this amazing life, but we know there's a different league, right? In terms of money. And once you, if you start making the huge numbers, you enter that league.
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And then it's very hard to leave. And you see that people that are in that league are not necessarily more happy. They're usually less happy, more egocentric, more selfish, doing more harm to the planet, doing more harm to people, worrying more about the things that don't matter.
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And it's stimulating a type of world that I actually don't like, and I'm desperate to enter that league. It makes no sense. Something is wrong. So I'm kind of realizing that and saying, no.
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that's not where I want to be. I think Chris Williamson calls it, do you know Chris Williamson from Modern Wisdom podcast? No. He's a British guy, lives in the States now, but he's got quite a popular podcast. He calls it an unteachable lesson, which is a lesson that you have to go through to learn the lesson. No matter how many people tell you that money is not going to bring you more happiness, you, in your own mind, will say to yourself,
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Yeah, but for me, it will do because of X, Y, and Z. And then you get there, and then you realize it. And you try and pass it on to the next person. Yeah, and we want to prove something to somebody. That's probably one of the main reasons why we go down that path. We want to prove something to somebody. Yeah.
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Because what we have today is already more than enough for us to be the best version of ourselves and as happy as we can be as in peace. More than happiness. In peace. That's exactly the word I use as well. Right? Be in peace. And every step towards the journey of making more money will make us less in peace from now on.
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And everybody tells us, everybody that went through it, it's the lesson that we cannot teach because we see the stories and we repeat the mistakes.
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And then we get to 98 and we're like, why the hell I wasted so much time with this, this, and this? Why I didn't spend more time? Like everybody that is dying, about to die, they say exactly the same thing. Exactly the same thing.
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Yeah. But I heard an interesting reframe on that because I agree with you. One of the most, if you listen to the palliative care nurse who tells you about the stories of those who are in their dying days, like what would they have done differently? I think everyone...
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Everyone says the opposite of what they did and they don't necessarily bring into frame the fact that everything has a sacrifice associated with it. Like if you want to fulfill your the opportunities that you have with the skills that you have in your life.
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that's going to take you down a certain path. And if that's a professional path, then that is going to be at the detriment of not seeing your kids enough, for example. Or if you spend all your time with your kids and you become a super dad, house husband or housewife, and that's your full focus, you're always going to think, oh, I didn't quite make the most of my potential that I have. So I think you have to accept that there will be sacrifices in both directions.
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I really like, I really love the frame of like work for your 100-year-old self. And like when you're lying on your deathbed, make sure you're making decisions consciously as to what would make that person happy. And I just always come back to balance, I think. I think you've got to just constantly, like with your portfolio of stocks, you've got to be constantly reallocating the assets, re-diversifying to balance it out. Fine. But balance is a word...
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that I think is overrated. I agree. There's no, can we say bad words? Absolutely, yeah. There's no fucking balance in life. And if you want to do good things, there's no balance. I gave up on trying to find balance. Like, if I decide I'm gonna write a book,
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If you want to find balance, you're not going to write a book. Right? You've got to go all in. You have to go all in. Yeah. But it needs to be something that first, you're doing it for the right reasons. Second, it's very open and honest with the people around you that loves you. So they are with you. They understand. It's not a selfish decision.
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And you need to deliver what you promise to yourself because it's going to make you feel... Intention. Yeah. Yeah. You know, so one of the biggest frustrations that I see is that we are constantly sabotaging ourselves. We're promising ourselves that we're going to do X, Y, Z, and then we don't. And then we create excuses for that, and we rationalize it.
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And then we continue and then we make more promises to ourselves. I always say, next year, I'm going to do this. I'm going to stop doing that. I'm going to be more here or I'm going to be more there. So I don't think it's about balance because I'm not a balanced person. I'm constantly all in this or all in that, you know.
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And I think that's beautiful. So I think balance is important, but the definition of balance needs to change. Mm-hmm.
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It's a constantly moving and flowing balance. Sometimes you're all in, in something that you're really passionate about. Sometimes you're back with the children. Is that fair? I think when you are doing something, you need to be 100% present. Yeah. That's more important than balance. Which is very difficult in the modern world with social media and the phone and everything else. Exactly. You need to make
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non-selfish decisions with the people that you love, your close family. So it's like when I say I'm going to write a book, it's not me. It's the whole family is going to write this book. Family. I'm thinking about writing a book. That means that we're going to have to create a strategy that will allow me...
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to write a book. My wife said, I'm thinking about going back to school and studying, going back to university at 40 years old. That's not her going back to university. It's the whole family that is making the decision together. Right? And she's like, wow, I feel guilty because I'm not...
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actually generating revenue with my work. I'm back in school and I'm not enough with the kids as I used. And I tell her, look, this is a team effort, right? It's an amazing project. It's a family project. And even though the kids are small, they will understand.
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And they will feel proud of it. And when they're 20, 30, they're going to talk about it. You know, we all helped mom. We were part of the project. Look what she did, you know. So it's not her going back to school. It's the family going back to school. Yeah. And so that means that...
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Balance means making non-selfish decisions. And even if you have to go full power into one and giving up on other things because you're always giving up. If everybody around you is on board, you find this new balance for a few years. And then you redesign what balance means. I'm traveling more than ever to lecture.
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But I feel more balanced than ever because for the first time, my relationship with my wife is more honest about it. We are more open. We became a better team. And we are on the same page of why I'm doing this. And when I'm at home, I'm much more with the kids. But when I'm traveling, everybody understands why.
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So what I called lack of balance 10 years ago now became balance.
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Yeah, so it's the definition of balance that's the key, right? And it's your own definition. It's not a utopia. It's a team decision. It's not a utopia that you achieve when you finally reach work-life balance and you have it perfect forever. It doesn't exist. Balance is like six hours of work every day and then staying with the kids this amount of time. Usually you don't get things done. I love people that get things done. That's another. I said that I'm more and more admiring the people that are,
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have the courage to say no to the numbers and focus on their artistry. I'm just in love with these people. And I'm also in love and admiring more and more people that actually get things done. Because I'm tired of good ideas.
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Yeah, I completely agree. Oh my God, I'm so tired of my own good ideas. Everybody's good idea. Everybody has a great idea now. Well, with Claude and with AI, you've got an idea-making machine there for you. So that's not... Spitting out ideas every day. That is not the difference anymore. Yeah. AI is telling us, you guys think you have good ideas? What's this? It's a joke, right? So now I love people that are like,
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even more people that take average idea and implement it and make it work.
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Like Christian, you had this idea. The idea was okay, but here, it's done. Yeah. It's working. It's actually executed and functioning. It's not like almost there. No. Yeah. It's not perfect, but it's functioning. People are using it. People are benefiting from it. Right? It's implemented. Yeah. Implementation, execution, implementation.
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It's an underrated skill. 100%. I mean, that's why I'm so proud of what we've achieved with Parler, because it's like, how many dentists over the decades have spoken about launching a toothpaste brand? And it's so easy to say, and it seems so easy to do, but how many of them have got it on the shelves of the major supermarkets and the pharmacies? Yeah.
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Yes, we have challenges. Yes, we continue to adapt and grow and improve. But it's done. But at least we did it. It's done. The better off or worse. And as you say, you have to build the plane or build the parachute as you're jumping out the plane or build the plane as it's going down. On the fly. But at least you're in the game and you're in the arena. 100%. 100%. And we were saying last night about how the various, very savvy business individuals that we've met across our careers, there is one...
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common theme amongst all of them, which is they are rapid. They are in your inbox. They will message at whatever hour. They just want to get the job done and then continue to grow and progress. And I think that's – I think for me, certainly my –
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I was chatting with my business coach about this last week. I'm the sort of person that overthinks everything. And that's a blessing and a curse because obviously you worry about everything, but also you see into the future a little bit. But I always force myself to still execute. Even if I'm really worried about it, I still just jump out the plane anyway and then just deal with the consequences afterwards. Sometimes that's,
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emotionally challenging for me. But it's the only way I know how to be because I have to just follow my curiosities, follow my passions and maximize my potential is the thing that I always come back to. No, executing, building something that is already implemented and working is...
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for me, the most important skill nowadays. Because theory, it's all over. Information is all over. Ideas, all over. But actually, creating something out of it and
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And then going through the process of working with people, finding the resources, working with the limitations, being okay with not being perfect, and just...
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Finishing the project. It's done. Right? Now I can decide if I want to stop it. I quit. I want to continue. I want to move away. I want to put other people to run it. But the project, the idea became a project. The project became implementation. Implementation became reality. The project is over. Conclude it. Yeah. Check. Right? Um...
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And my big challenge now is to not only say that, but to become that. I mentioned the book. I need to write a book. I know I need to write a book. And every time I start, I sabotage myself. I find excuses. And I need to get over it. And I need to...
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finish it right otherwise i know when i'm 98 i'm gonna be talking to myself you piece of shit you know it doesn't matter how good or how bad the book was yeah you didn't do it you didn't do it it's fascinating there's a lot of um just talking about going all in on things and having lots of projects
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there's a lot of stress and burnout in our profession. I don't know if you see that globally as well. I mean, certainly in the UK, we see it a lot. Is that something that you've ever struggled with before? Have you ever had periods of burnout or sort of extreme stress? I'm, I don't know if it's genetically. I'm pretty good under pressure.
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I don't know if it's the education I got or my personality. That's why I succeeded very much as a speaker, taking risks, embracing the crowd and just to say, I know I can deliver even if I'm not sure what I'm going to say.
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But I did have moments. I remember my biggest crisis when I was 30, recently divorced. I moved from Brazil as an immigrant to U.S. I thought I could speak English, and I realized when I was in U.S. that I didn't. I couldn't speak English. New country, away from family. Yeah.
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not having a wife anymore and away from my son, my first one. And yeah, I got into depression and not being able to sleep, you know, insomnia and anxiety and.
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At one point, when it happens to you the first time in your life, you think you're going to die. I have some kind of illness. I have no clue. I cannot get out of it. I don't know. I think the hair was falling like this. I couldn't function physically. I couldn't have a girlfriend. There was...
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So yeah, I went through that. And after one year, you get out of it and you're like, damn, this wasn't that bad. I got over it. It's part of life. Now I understand that everybody goes through this, right? How did you get out of it? Of course that you need to have a certain foundation, and that's what many people probably don't have.
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the belief in yourself, and that comes from your childhood, it comes from education, it comes from family, it comes from schools that, you know, different type of education that stimulates your creativity and your belief in humanity, you know, believe in the good,
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Because it's not performance or numbers or professional success that will take you out of this situation, right? It's something much deeper. When you're like, I think life is not making sense or I think I'm dying at 31, and then you sit down with yourself at the bottom
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of the moment, like the deepest, darkest moment, and you're sitting with yourself, and you're like, life is good. People are good. World is good. I don't want to leave this place. And you find that inside of you, and you're like, I don't know how, but day after day,
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it makes sense to get over this. You know, it needs to make sense. I wanna get over this. And no pressure, don't be too hard on yourself, you know. And so I found something inside of me and I think that's the only way, you know. And of course, I know family is there. I know friends are there.
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But at the end of the day, something on your childhood creates that foundation. And it doesn't mean a perfect life because I see that in people that were... grew up in the favelas. And they have that inside. I see people that are in Gaza or Ukraine or Venezuela and they have that inside of them. So...
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It's not like you had a great life, you had great parents, you went to a great school, so you have it inside of you. No, it's not. So I don't know exactly how to increase the chances of a kid having that inside of you. But I think it's related to creativity, stimulating creativity, because when you are naive and creative, you make fun of yourself,
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You are able to play with life. And when I was at the bottom, I started to laugh about myself. You know, you have so many things in your hand and you are like behaving like shit, you know? And I started to smile. In the worst day of my life, worst moment of my life, I started to smile and make fun of myself.
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in a candid way, in a, like, yeah, man, don't take yourself too serious. If you thought you were the coolest guy in the world, you're not, you know. Just, just, be okay with that and, and, and don't take yourself too seriously. The moment you don't take yourself too seriously, you don't take, you take
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kindness seriously, but you don't take what we call problems too seriously. Your depression is like, where? Why? Like things, you know, just dissipate the smoke and suddenly you're lighter and you stand up.
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Yes, let's keep going and smiling. And if I have a problem tomorrow, I'm going to smile at it and say, okay, let's get over it.
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And do you think that period of sort of, as you describe it, the sort of bottom point of your life has led to living the 20 odd years since then in a different manner? Living different lightness in the last 20 years since that moment. Do you think it changed how you view life? Oh, yes. Yeah, the main lesson for me was that.
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Don't take yourself too seriously. So it means when you think that you're a piece of shit, don't take yourself too seriously. When you think you are the best in the world, don't take yourself too seriously. So that eliminates the extremes. And that's when you find you're more in peace. I'm not this, but I'm not this. I'm just a good person trying to do my best.
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So don't take your ideas too seriously. Don't take your success too seriously. Don't take criticism too seriously. Don't take compliments too seriously. And you become more in peace. That's why when you talk to very wise people and you say how amazing they are, their reaction is very subtle. And you're like,
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You know, why? I'm just saying you're the best in the world. And you see how serene the person is. And then the same thing when the world is falling and somebody, you know, is drastically, deeply attacking that same very wise person. And you see that same kind of wise reaction to it. Like, calm. So...
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not taking things too seriously, the mundane things too seriously, and only take seriously the things that really matter, and that is generosity, basically, being generous. That's the only thing that you need to take seriously. And by taking generosity seriously, it only brings good feelings to you. The problem is that
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We forget that and then we start giving too much importance to everything else. And then we start not to be generous with others and with ourself. And of course we're going to suffer. Yeah. And then our brain tries to find excuses why we behave like that. So the moment you have that connection, you accept that, you become a more stable person, more in peace. Mm-hmm.
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Yeah, I think peace and stability is what we should all be striving for, less on the extremes of the emotional spectrum. Yeah.
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Not easy. I'm not saying I have it under control. Well, I mean, I think that's also a really good frame is that not striving to be the finished article at any point and looking at life as an infinite game that you continue to improve. Much like our dentistry, as with us as a human being, we're constantly looking to...
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get a little bit better every single day as opposed to making it to some imaginary final point that doesn't really exist. So I want to bring us back in, Christian, to something you mentioned earlier on when I asked you about the last 13 years. You said at that point we were trying to persuade people to start...
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utilizing technology more and certainly at that point I mean I was using a CEREC Omnicam but scanners were very nascent in their implementation across the profession chairside manufacturer of restorations although CEREC had been around for many years still hadn't really made it into the mainstream arguably probably still hasn't quite yet
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but we'll come on to that later on. But you mentioned then that maybe people now are looking at technology too much and they're maybe, are they using it in the wrong way? Are they trying to implement it in every environment where actually, in your view, sometimes the human connection is actually the more important part? Where are people at the moment, do you think, misguided in their view on technology? So there are two problems with technology. First...
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is that we are using technology. We are not using technology where we need the most help. That's problem number one. And problem number two, we are camouflaging our deficiencies, our human deficiencies with technology.
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and we are creating marketing stories based on technology and not highlighting what really makes the difference. So, problem number one, we are not leveraging technology where we need the most help. Basically, you can divide dentistry, very simple, into a few moments, right? First moment is that
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To be able to treat somebody, first we need to attract that somebody. Otherwise, you don't do the dentistry. After somebody comes to you, you need to understand the person. You need to understand the problem. You need to collect information. Clinical, emotional, technical. So, somebody comes to you,
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Then you understand the person. Then you need to know what to do with the information that you just found out. Basically create a plan. Then you need to convince the person about your idea. And then you need to execute the plan.
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And then you need to maintain that situation. So this is dentistry. That's what we do consciously or unconsciously every single day, intentionally or unintentionally. We are attracting people to us. We are trying to do a clinical examination and see what's going on. We are processing what we are seeing and building a plan. We are convincing the patient that our plan is the best for them.
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Then we are, if the patient allows, we are executing on the plan. And then after that plan is done, we are trying to maintain that relationship, maintain that healthy situation as long as we can. And then we repeat over and over and over again, right? The problem is that dentistry is completely biased towards executing.
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right? Executing here, step number five. And then in the last 20 years, dentistry got obsessed with marketing. One. So one and five. And in my understanding, these are the two moments that we shouldn't be focusing that much and we shouldn't be
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That's not where technology will really transform our dentistry. Why? Because execution, we've been executing amazing dentistry without technology for decades anyway. So I do believe technology can allow us to do a little bit better. But that's not where we struggle. I did dentistry without technology. The best dentistry I ever did in my life
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was without technology. So we are biased towards performing, towards execution. Education is focused on execution, how to do things, how to execute a technique, a procedure, how to handle an instrument, how to use technology to perform. And that's not where we make most of our mistakes.
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We make mistakes much more related to diagnostics, treatment planning, and patient communication. That's where most of our stress comes from, our missed opportunities. Our dentistry quality is defined by the quality of our plan, not the quality of our execution. That's why an architect makes more money than the engineer.
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that will execute the plan. You know how much, you told me about the remodeling, by the way, amazing, beautiful house here. You know, you probably had an architect that I can see was very, very good architect. And then you had somebody responsible to execute that. And we know who makes more money. Yeah. We know who defined the success of this project. It was not the builder.
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was the designer, the planner, the visionary person. So because dentistry was biased, is biased towards execution, every single company is biased towards execution. So every single technology that was developed so far in dentistry was focused on execution.
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not on diagnosis, planning, communication, exploration. And after 30 years of digital dentistry, we see only now companies starting to wake up. That, you know, before we execute something very well, we need to understand what do we need to execute? Why do we need to execute? What are the reasons why we need to do X and not Y, right?
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And that was always my passion since the beginning of DSD, exploration. I call it the exploration phase. You're my patient. You just came to me for the first time ever. And I don't have a clue who you are. And I'm going to open your mouth and I'm going to be biased. And I'm going to be superficial. And I'm going to want to jump into execution.
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And that's the missed opportunity. So dentistry needs to work back and we need to leverage technology where we need the most help. And that's where the revolution is. Using technology to explore better what is wrong with the patient, what is right with the patient, what are the options, what are the possible specialties that we need to activate to help this human being.
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in what order, in what sequence, what timing, building, diagnosing, developing the prognosis, exploring the chances and probabilities and risk assessments and pros and cons and possibilities and simulations and interconnected possibilities of different procedures and making all the mistakes on the computer before we touch them up. And then onboarding the patient to the story.
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as I say, diagnose, plan, and present. That's where the magic is. That's where the revolution of modern dentistry happens. We need to become amazing diagnosticians that we are not. Dentistry needs to wake up for the fact that we are very bad diagnosticians because we were not educated for that. We were not taught. Dental school is not focused on that.
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And the very good ones, the ones that are good at, they are good at the traditional oral biology, oral function, oral structure, and oral aesthetics. How shallow is that? Since the mouth is connected to a whole damn body. And people have a hard time admitting that.
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that we are superficial, that we are biased, that we are inconsistent when it comes to diagnosis and exploration of the whole world.
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body-mouth connection, oral systemic link, health. I mean, even higher up than that, we diagnose in dentistry, bucketed into different specialties. We diagnose in perio, we diagnose in caries, we diagnose in- It's fragmented. It's fragmented even at that level before you even incorporate the rest of the body. We're still having a hard time integrating ortho and restorative. Yeah, exactly. Can you imagine that?
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Like, if you're going to move the teeth and restore the teeth, we better plan this together. Yeah. You still need to convince people about that, right? Companies, you need to... It was very hard to convince companies about that. Your software needs to help us understand the connection between moving teeth and restoring teeth. Well, that's what you did with Invisalign and DSD, right? So it took us several years, right? Right.
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Because companies were already making so much money in a fragmented way that they were like, why bother? No incentive. Why bother? And the dentists don't even want this. Why bother? So this is an ongoing mission and was one of the first missions, I would say, from DSD. Because I was a technician that fell in love with orthodontics. Why? Why?
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Because I started to do wax-ups, diagnostic wax-ups guided by the face. I don't care about the mouth first. I care about the face first. So I start from the face. And when I do a wax-up from the face, that nowadays I understand is even more beautiful because starting from the face means that you're starting from airway as well. Yeah, very much so.
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what makes sense, the end in mind. And every time I would do a wax up with the end in mind, I would look at my wax up and say, this is not only restorative. How can I convince this restorative dentist not to jump orto, not to skip this, not to miss the opportunity, right? And that was the beginning of DSD. Through the drawings to try to convince people
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of connecting what was fragmented, thinking bigger, exploring a better option, giving ideal a chance. So we are fragmented.
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So we just need to accept that and fight against it. I like to talk about these things because I'm repeating this to myself, not to get stuck on the comfort zone and push myself towards the unknown, right? Because we don't know much about...
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what is out there. That's why it's so uncomfortable. That's why the academic world is so uncomfortable. It needs to be, you know, I love the concept of evidence-based dentistry. Cool. But give me a break. Everything that is evidence-based today was not evidence-based
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at a certain point in the recent past. Yeah. So what the hell? It's also not based on today's knowledge. It's not based on old knowledge. So you need to say, this is already proven. This is not proven yet, but it doesn't mean it's wrong. It doesn't mean it's wrong. You need to leave some space. Don't be so arrogant. Right? So doing something that is not proven, you need to be aware of it.
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And you need to be honest with the patient. But patients are getting smarter and smarter. They know how much medicine doesn't know. We were talking about this yesterday. Medicine and dentistry, when it comes to total health, maybe knows 5% of what we, of the whole picture. And we think we are cool. We think we are doctors, right? Physicians.
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They always have an answer, but in my humble opinion, 95% of the time, they have an answer because they feel pressured to give an answer about something that they are not sure that they need to pretend that they are sure. And the danger is when they think they are sure, when we think we are sure,
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Right. Like we see with all the trends, you know, if I'm an airway dentist, I think that all the problems in the planet can be solved through airway. If I'm a fanatic TMJ dentist, I think that all the problems in the planet can be solved through the TMJ topic. Yeah.
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Or occlusion, you see crazy people about, oh, my device solves even the war in Gaza with my oral appliance, right? Or now biological dentistry, we solve everything. Biological dentistry, we solve everything. Even though they just started, they are in the infancy. And then the arrogance of humans, right? Say, I found something that has potential, it's already the answer for everything.
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the trend because then academic world is like you're a charlatan. You're promising things that you cannot promise. So the academic world is partially right. Yep. And there's always a commercial interest somewhere along the line as well. And then comes the ego, and then comes the money, and then comes social media, you know, I'm becoming a influencer on this topic.
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And then we get blind, stuck in our bubble, and then Instagram reinforces your story with fans that without knowing are saying that you are amazing, that your story is the true. Yeah. And then you reinforce that. Because everyone now is looking for the contrarian view as well. It's very much like a modern social media environment where…
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nothing of old can be true and everything new must be right. Do you know what I mean? Because we've seen it now. We've seen various old frameworks be broken down and proven to be incorrect. We now assume that everything that was old and is a framework should be broken down and repositioned. So it's very difficult for people to know what's true and what's false. So you need to value the past. Yeah.
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You need to value what was proven. You need to value the mistakes that were done in the past. We need to value the conclusions that are giving us the most common sense solutions of today. But we need to be open about what we don't know. We cannot be arrogant enough.
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about what we know today because we know it's just a little piece of reality. And basically what I'm saying should be common sense, right? Absolutely. It should be common sense. What we know is just what we know.
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So one of the quotes that backs this podcast is strong opinions loosely held. And I think it's exactly that point. It's you need to be strong in your opinions. You need to be passionate and have some vigor that you put into what you're doing. But you also need to be...
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able to let it go when new information presents itself to you. And I think that's where a lot of people I see hang on to that strong opinion as if their life depends upon it and they're unwilling to accept new information. Having certainty is one of the most stupid things for a human to have. You know, I'm certain. When you are certain, you're lost already because you cannot be certain.
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You cannot on a blind way. You need to be confident about your decision, knowing that nothing is certain. You need to be ethical about your decision, knowing that you can only see partially the topic, that there's many blind spots that you don't even know about it. So we need to be aware of it.
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So I'm not saying that you shouldn't be confident. You need to be very confident. When you have enough information to make a decision, you need to be confident. It's beautiful to be confident. I call it humble confidence or confident humbleness. That I'm confident because of several factors that are giving me this confidence, but I know that this confidence...
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is just based on probabilities, not certainty. I believe that there is probabilities that are bigger enough for me to be confident about this path, this decision, this treatment, this diagnostics, right? This suggestion I'm confident about, but I'm not certain about anything. We shouldn't be certain.
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Yeah, being comfortable with uncertainty is a really challenging position to hold and one that I think we should all be striving to get to. It's easier to be certain because you eliminate so many things. We need to be comfortable with uncertainty. Yes, that's the beauty of very wise people. You talk to very wise people and that's what they are.
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they're comfortable with uncertainty. Well, it's, I mean, that comes down to, I, the first thing I think of is a fear of death. And I mean, a fear of death is a fear of uncertainty. Yes. The fear of the unknown. Um, and we have to, hopefully with our passage of life, we gain the wisdom to accept it. Yeah. Acceptance. Of how much we have no clue about. Um, um, you know, I,
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And I love talking to people that have that humble confidence and calm serenity when facing uncertainties, and they're just okay with it. So as doctors, we don't have to be certain. We cannot feel that we need to give an answer to everything.
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And we need to admit that most of the questions, we don't know exactly the answer. And when we have an answer, it's based on the things that we know that are just a piece of the total. And I think it's just beautiful to admit that in front of the patient. The smart patients will deeply appreciate that. They will feel more secure. You're going to gain their trust.
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And any patients that expect 100% certainty from you are the ones that you should probably have some red flags around anyway. And then you need to use your communication skills to bring them through this situation that they understand what we are just saying here. I'm not certain, but if I communicate well, you as a patient will realize...
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that the chances that I'm correct are bigger than the others that you're looking into. It's all about chances. It's all about probabilities. Yeah. And I don't think trust comes from certainty. The people that I trust, I don't trust because I know they are certain about X, Y, or Z. I trust them because they are aware of...
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of how much uncertainty it is around every decision. Yeah, that's a really good reframing. I'm keen to make sure that we tap into your...
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framework workflow mind and provide as much value to the listeners as possible in that execution. You mentioned earlier that diagnose, plan, present are perhaps the areas where we're under utilizing technology currently. Mm-hmm.
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Are we in a position right now to be able to give the listeners any tools that they can use straight away in those areas or even maybe ways in which they can improve that crucial part of the patient journey? So we need to push the industry to develop the tool. Technology is ready. As I said, you start to see companies starting to develop
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tools that will help us where we need the most help. And the question is very simple. When you see a new technology and you're trying to prioritize your investments as a practice owner, my question is, is this new technology will help me where I need the most help? And in my opinion is, can this technology help me to diagnose, plan and present? As simple as that.
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So when a company comes with something new, you ask the company person, it's like, how can this help me diagnose my patient, understand the problems of my patient? Because that's the most difficult part, right?
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I have my traditional clinical examinations. I take my x-rays. I'm starting to use blood tests, maybe saliva testing. Now I do CBCT sometimes. I have jaw tracking to see the movements and TMJ and digital perio charting and...
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AI helping me to see maybe or confirm things that I'm suspicious about? How can this new technology that you're presenting to me help me even more understanding what is going on with my patient?
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Yeah, I think the diagnosis part of Diagnose, Plan, Present is probably where the technology is most advanced currently. Obviously, we've got multiple companies providing AI-assisted radiographical diagnosis. We've got, as you mentioned, we've got the salivary testing companies now coming in, providing us with additional information around the oral microbiome. People like Oralis. I've got Victoria coming in next week for a pod on that.
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uh dentog uh what's the brand called dentog uh diagnostics that's it they've got systems i've got a blood testing machine in my in my practice that gives point of care vitamin d hp1 ac i guess it's connecting all of those pieces together that becomes we're getting tools we're getting more and more tools uh you know the topic of body mouth connection finally became a
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People are like, okay, so the mouth is connected to the body. Breaking news. Maybe what we do in the mouth has a consequence in the body, and maybe what is happening in the body has something that we can see in the mouth. Finally, right? But still, it's just the infancy of this exploration, right? We have companies in a fragmented way giving us tools, right?
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AI is pretty much focused on imaging, reading images, right? So there's much to be developed in terms of helping a dentist to connect all the dots, the big picture. So I did a clinical examination, I made my list of findings. I have a CBCT, I have saliva, I have blood, I have AI imaging.
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I have a sleep quality questionnaire. I have a TMJ assessment. I have the traditional biology function structure aesthetic assessment. General systemic health information. Man. Man.
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bringing this all together and getting into some conclusions, it's hard. So many variables, so many unknowns. The saliva testing is giving you something and giving you a little script of what that little something means. But blood test is another something, and whatever you're seeing on the CBCT is another something. We're lost, I can tell you. Even the people that say no, they are lost.
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The best biological, integrative, functional dentists are pretending they are not lost, but they are lost with all this information. Yeah, they're making the best decisions they can with the information they have. But to say that I have everything under control, it's a lie. Right? Because we just started to talk about all these things yesterday. Right? And everybody says something different. Oh, if you see this, you need to do that. If you see that, you need to do this.
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And then the problem is that we pick one thing that we like. Of all these diagnostic worlds that I just mentioned, we pick something that we like and we deep dive in that and then we kind of forget the rest. Do you not think that's kind of the way we've been trained slash the narrative that is in our profession that
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Like, I like being what I would define as a super GDP. I like to have a breadth of knowledge. But do you potentially, by doing that and by trying to stay broad, become a jack of all trades, master of none?
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Whereas the counter to that is what you're describing, which is I'm an airway dentist and all I look at is airway, which is the wrong way to do it, right? We should be looking at the whole picture. So who's the right person to do that? We super value the super specialist and we undervalue the super generalist. Dentistry is desperately needing super generalists. Healthcare.
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like the old school family physician 100 years ago, was doing a better job understanding the human being than the super specialist with all the technology today. For me, that is very clear. And if you go back 3,000 years, ancient Chinese medicine, they were doing a better job.
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Interesting. Then 99% of the best physicians in the best hospital in the best countries in the world. In what way? Because they were not biased towards one thing. They were first connecting to the human. Second, they were following that human since baby
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No, I've been your doctor for 40 years because that's the way it used to be. So the original bespoke medicine, in essence, based on the individual, not the mask. And I have things that I don't even know how to explain about how I understand who you are as a patient. I saw you. I was there when you were born. You grew up. You're an adult now. And I know you. There's no way we can beat that, right? Right.
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There's things that's hard to explain. Then the way in the old days, they had this broad perspective. There was no specialty. The specialty was health. I'm gonna help you. I'm gonna try to help you be healthy. That's it. Then nowadays we are super specialists. That means that we are very good treating,
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Extreme situations. That's where medicine really thrived and where we shine in dentistry as well. You got into a car accident. You lost teeth, bone, everything. Dentistry shines there. We can reconstruct. We can solve emergencial problems, extreme problems, right? Medicine and dentistry are very good at that.
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It's because it doesn't require really a diagnosis. No, the problem is clear. It's back to point five. It's execution. It's execution. It's performance. It's technique. We can do that. We can do that. But when we talk about prevention, when we talk about longevity, when we talk about chronic disease, when we talk about issues that are not clear, issues that are just there slightly bothering that human being, issues that will take...
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10, 15 years of your life at the end of your life, little by little, things that will harm the quality of living on the last 10 years of your life. These things, we are not good. Yeah, it's the sort of 10% bone loss every 10 years that we let it creep up on us. Connections into the hole. So for me, you have dentists
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doing simple dentistry, that they, you know, the GP, the general practitioner is doing simple things and the super specialist is doing the complicated things.
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That's why we overvalue the super specialist. But for me, above the super specialist is the super generalist. So you have generalist, specialist, and the super generalist. The super diagnostician, the big picture doctor. That's the term, isn't it? Diagnostician. The big picture doctor, right? The one that knows a little bit about everything. The one that follows the patient long-term. The one that is not biased.
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the one that can be a super specialist in one of the topics. But every time this doctor is seeing a new patient, he's taking his super specialist hat off and putting his super generalist, his super diagnostician hat on.
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and unbiasedly doing a comprehensive exploration, a big picture exploration. And then the super generalist is the one that needs to activate the super specialist. The super specialists need a quarterback, a leader, the super diagnostician. And that is what is missing in medicine and in dentistry. So how does one...
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get themselves to become a super diagnostician. First, you need to love this topic. If you're listening to us, you need to be listening, getting goosebumps about it. Like, damn, that's my art. That's what I want to do. And the market is begging for it. And smart patients love it.
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the good patients, they love this. If you put a patient in front of me and you give me five minutes to explain this, there's absolutely no patient in the world that will not agree with it and not want it. Yeah. I'm desperately trying to find these dentists. Right? So first thing, you need to love it because it's a mission. It's a purpose in life. It's something that you need to really embrace. Second thing,
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you need to identify your biases. That means the things that you love doing the most in dentistry, the specialties, the techniques, the areas of dentistry that you like and you need to put it aside. I'm still wanna do this, but after. And I need to know the moment that I wanna be the super specialist. And super specialist, I don't mean only
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the traditional endo, perio, ortho, surgery, specialist, anything that you do very well, you become a super specialist on that. You need to put that aside. And you need to perform the exploration phase, putting that aside. And then you need to be very smart reinventing your first appointment.
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You need to be very smart picking just enough from each specialty to generate this amazing new gold standard of first appointment that is a complete exploration. And the challenge of this is because you need to learn from specialists just enough to bring just enough to your super exploration first appointment. And the challenge is that as you go to the specialist and you say, I need to learn from you just enough,
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they will try to convince you to be a super specialist because super specialists think that their specialty can solve all the problems of the world. And you need to be strong enough to say, look, calm down, this is too much information. I don't wanna be you, I already have you. I wanna refer to you. So you just need to give me enough because I only have one hour, an hour and a half for this appointment and maybe one hour second appointment to present the ideas.
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And I cannot spend eight hours with my patient. I need to be smart and I need to condense and I need to filter to have the most effective, efficient first appointment possible that allows me to explore the whole. So you love airway and you're telling me to do a questionnaire that will take a half an hour. Just about airway. But airway is not everything. And if I do, all I need is to raise the yellow flag.
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And if I find that airway is actually the main issue or one of the issues, I will activate you and I will bring you into the game. And then you can deep dive in this because I saw the yellow flag, right? And then we need to do that with airway, TMJ, chronic pain, systemic issues, aesthetics, biology, function, structure. We need to do that with...
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Saliva testing, blood testing, you know, we need to understand the whole as much as we can. Yeah, see the whole field. And so immediately when you say that, I do get goosebumps about that sort of thing because I think that is exactly me. But my first concern, I guess, comes as a realist in terms of
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the business side of dentistry. And again, this comes down to communication, I think. But if you're going to do this super exploration, patients or potential patients will potentially, before they meet you, view that as a dental exam. And they'll compare it against other dental exams. And then they'll see that your dental exam, as they see it, costs...
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300 pounds, 300 euros, whatever, 300 dollars. Because it's so much more...
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Have you seen this done really well in terms of the communication? Because something I've started, I'm redoing my website at the moment and something I've really struggled with is knowing how to term what we're talking about here. Like, is it biological dentistry? Is it longevity dentistry? Is it the mouth body connection? Is it dental optimization? Preventative dentistry? I don't know what to call it. I know it's in there. I know it's,
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Like the, as we were discussing last night, the Peter Attia version of dentistry that I want for myself and I want it for my patients. But how do we frame it for the patient in a way they understand? So a couple of things. That's a great question.
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The first thing is that all these names, unfortunately, already have a negative stigma coming with it, right? Because all the opportunistic charlatans and people taking advantage of all these trends and saying that what they have is the solution for everything. People getting skeptical, the academic world, saying that this is BS and so on with a certain level of reason. So we need to be very careful with names. At the end of the day...
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For me, this is dentistry. We should call it dentistry done by an oral physician. So I'm upgrading myself from being just a dentist to an oral physician because that's the way modern dentistry should be done. Okay? The best way to frame it, since you mentioned Peter Atia, for me, and the way I...
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explain it in a way that I see the reaction of people like, wow, this is it. It's like, if you choose me as your dentist, you're not choosing me for a treatment. You're choosing me for a lifetime. It's a forever partnership. That's number one. It's the same way that when you find your best physician,
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And we were talking yesterday, we are both trying to find our Peter Atia, there are not many out there, a lot of podcasts and people talking, and then you go to see them, and you see them, right? Blah, blah, blah. So, I'm that dentist for you, okay? And the best way to explain the difference of this dentistry is that as a dentist,
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I'm focused on the impact of our decisions today on the last 10 years of your life. Period. We all gonna die. We don't know when. You don't know when you're gonna enter your last decade. If you're gonna live until 105, when you hit 95, clock is gonna start ticking without you even knowing.
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How are you going to live those last 10 years of your life? This became my motto on every decision that I make today. Professional, psychological, physical decisions that I make today, that for me was the biggest lesson, aha moment. So when I'm having a glass of wine with a friend like we did yesterday, I'm thinking about the last 10 years of my life, and I'm consciously saying this is going to help me.
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This was a great evening and I'm embracing that glass of wine. And the whiskey. And the whiskey. And the limoncello. Okay? And dentistry has a huge impact. Huge, huge, but just insanely huge impact on the quality of living of your last 10 years of your life. Yeah, 100%. Like huge. So...
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Now, patient, you can choose. Dentists that never even thought about it and with the best intentions, even ethical dentists, great clinicians that don't think about consciously, intentionally about the impact of their decisions on the last 10 years of your life. I do. Yeah, I love that. That's brilliant. So I'm saying this to myself, that's the dentist I want.
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Every decision. Aligners or no aligners. It's not about aligning your teeth so you look better in six months. Come on, I'm going to live until 105. Maybe that is good for me as well into the future. Doing veneers. Everything changes the perspective, you know. I know, and Peter Atia makes that question. How do you want to live your last 10 years? What do you want to do?
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What do you want to continue to be doing, be able to do? And then connect with dentistry. Extracting a tooth that is kind of compromised. Go study the impact of extracting teeth long-term. Mentally, psychologically, and physiologically, systemically. The impact of not having teeth in the mouth, doing an all-in-four.
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We don't talk about it enough. There's science proven that when you don't have teeth in your mouth, it's not only about aesthetics or function, bite, the superficial diagnostics that we do. No, bite is good. Aesthetics is good.
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Implants are integrated, that's all? Success. That's success. The proprioception, the psychological impact of not having teeth, the connections with dementia and the speeding up so many processes in your body plus chronical issues that can happen when you have extractions and when you have implants and when you have metal in your body. You're going to deny that? You're going to say that implants are amazing?
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And you see suddenly that if your kid is 20 and loses a tooth and you see dentists that are placing implants on everybody's mouth, say, oh, my son needs an implant. And for the first time, you see them exitating. Like maybe, you know what? I'm going to do a three-unit bridge. Damn it. Like, really? You're the implant guy?
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And you're going to make a crown with a cantilever on your son? Because you're not sure. But with the patience, you're sure. You know what I mean? Yeah, absolutely. Hmm. I find it interesting. So, because our son is 20, 25, and our son is going to live until 105, 10, 15, whatever,
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And you start to think about, God damn it, this decision now will have an 80 to 90 year impact in this person that is my son. Let me think a little bit more. That's the type of dentist that I want to become.
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Yeah. And then it comes down to working with whatever the latest information is, because when you say that, my immediate mind goes to my dad, actually, who is a dentist as well, and how he's always been of the ethos of save this tooth until it's dying day. Keep it going no matter what. And I've seen many young associates come through over the years who practice defensively and they will view the prognosis of a tooth to be unrestorable at risk.
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two or three degrees earlier than my dad would have done. 100%. Then the counterbalance to that is, obviously the more modern biological dentist view around root treatment and the chronic connection between that. And so it's hard for people, isn't it, to know what to do the best that they can with the information they have. I think that the test, the ethical test here is like,
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I'm not saying what is right and what is wrong. But I'm saying that at the moment we think about treating when a patient is 40, 50, and we think about this human being at 105, and we just stop for a few minutes and think about our decision, it's already great. Just this exploration. Second exploration, if this was my son, amazing exploration as well. So you get out of the auto mode.
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You get out of the, that's what I've been doing, so it's fine. It's ethical. Ethical enough. There's the bone. There's the hole. There goes the implant. So the other thing that I think needs to be said, very controversial, is aesthetic shouldn't be a priority.
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For some reason, modern society had completely distorted the meaning of aesthetics. We destroyed the concept of natural beauty. Unfortunately. And aesthetic dentistry is one of the professions to blame. Plastic surgery as well.
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the immediate satisfaction of perfection as if perfection was the most beautiful thing, when in my opinion it's not. So we will, society will be much, much, much, much, much, much, much healthier when aesthetics is not a priority. Just the consequence of the right decisions.
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Because yes, if you're happy, if you're in peace, you are a beautiful person. If you're in peace, you are a beautiful person. How beautiful it would be if we truly believed in that. Because I'm saying that, but I don't even think like that today. When I see a beautiful person, I'm biased towards physically beautiful instead of
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mentally and spiritually beautiful. Right? A beautiful soul almost. Yeah. I'm not saying that it's easy to become that, but we need to bring it down a little bit, the superficial aesthetics. We need to be okay with...
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with natural imperfections, we need to be okay. We need to start step-by-step changing society's perception of aesthetics.
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It's difficult though, isn't it? I mean, when you define yourself as a cosmetic dentist and then you see the relief and the happiness and the joy that you bring to your patients through giving them back their confidence and that smile, it's very difficult to... We came from a world that was better balanced, right?
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to fix people that were mutilated, that were socially impaired because of aesthetic issues. Now we are grinding down teeth of 20-year-old people to put veneers because they have an embrasure that is a little bit bigger or a cervical that is a little bit yellower.
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or a shape that is not exactly lateral, is a little bit smaller than they should be. That's insane because there's a microdiastema. It's crazy because you wouldn't do this on your son, on your daughter. You would fight with your daughter at 22 years old. Are you crazy to change these teeth right now? In the name of aesthetics.
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And I don't even think today that is more beautiful because I'm really starting to appreciate the people that are comfortable. If they are healthy, I really value health first, like people that are focused on their health and are really comfortable with the way they look.
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That is so attractive to me nowadays. So beautiful. Like you see that people are generally completely embraced the way they look. Yeah. And they're putting all their energy on being a better person and healthier. Healthier.
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Yeah, so as a society of dentists, we need to be encouraging more in that direction than have you thought about the fact that your laterals are slightly too small. Do you think you're going to care about that when you're 98? Do you think you're going to care that your laterals are... Right? And how can we... Of course, if the person is depressed, no, I want bigger lateral, bigger... We restore them. I'm not telling you not to do that.
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I'm telling you that is a process that I hope that we as society will move towards a situation where we don't do harm to ourselves just because the lateral is a little smaller than it should be. But I guess then if we're looking more at health and the patient comes in, they've got a very narrow arch, nowhere for the tongue to go, and there's crowding related to that.
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then obviously... That's relevant. That is living better towards the future. So expanding the arch, opening spaces, allowing your tongue to be better positioned, opening the base of your nose, allowing more air to come in, bringing your jaw forward, opening air behind, and having a...
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huge impact on the quality of sleep, that is investing on the future. That is looking better for the right reasons. And it's, as you said before, it's facially generated treatment planning, but not purely through cosmetics, but through health as a lens. That's why airway became so important for us. Because airway is the best representation of...
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of aesthetics following function. There's nothing more important for a human than breathing. And then you sleep better, you live better, you're in a better mood. Everything is better through better breathing. So you look more beautiful, period, right? So everything connects. That's why area is such a big topic.
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And helping people to breathe better is such a big topic. And it's right in front of us, right? We as dentists. From kids upwards. I mean, that's Megan's big passion. One year, two years, yeah. The earlier, the better. Because we know we need to fight against...
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the evolution of modern society. We need to fight against this trend that is shrinking our lower third of the face. And we need to help kids as early as possible to compensate that, to naturally develop space, naturally develop space. So a lot of what we're talking about here is our ability to communicate or how we communicate with our patients. And, yeah,
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I've heard you talk a lot in the past about story, and I don't think people really think about a story when they're talking to their patients. They don't think about storytelling as a key skill of a dentist, but that's obviously a very human skill. We've told stories since the beginning of time. All of our modern society is built on stories, our stories about ourselves, our stories about our gods, our stories about our society. 100%.
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Can you tell us a bit about how you believe that people should be focusing in on that story and how they communicate with their patients? We humans, we are driven by stories. We follow stories. We follow storytellers, right? So it's all about stories. Um...
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So if you know you have a good cause, a beautiful mission in life, beautiful purpose in life, nothing better than becoming a better communicator, better storyteller, to make the world better, right? We have too many selfish, powerful people that are great communicators influencing people for the wrong reasons.
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So we need more generous, unselfish people pushing the right things, becoming better communicators. You know, people, I love, for example, Simon Sinek. You can see the guy is just...
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Just kind, right? Just generous and working on the right direction. And because he's a great communicator, he's doing so much good, right? As oral health providers, we need to practice our communication skills to make these transformations that we are talking about, right?
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For me, it's what I mentioned to you. I started to think about, if I have something good to share, how can I make people listen to me? How can I increase the chances? Because as I said, it's all about probabilities.
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of more people listening to me. I call this the art of making people bet on us. What does that mean? It means that if we know we have something that, if I know I have something that will really help you, even if you don't know that yet, I know that somehow I need to allow you to see what I'm seeing.
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I need to make you bet on me. That's what we do in life, right? When our kids say yes to what we are asking, they're betting on us for some unconsciously. They're like, I was not thinking about this or I didn't want to do this, but I'm going to do it anyway. I'm betting on my dad. I'm betting on my mom. It's probably the right thing.
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When we are asking a business partner to invest on a project, we need to make them bet on us. They need to buy the idea, right? When we're trying to create, you know, when we are trying to convince our team to incorporate a new system or a new workflow, we need to make them bet on us first. They need to bet on us. Not pretend, but really genuinely bet on us.
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We need to have that skill to make them bet on us. When we are trying to convince the bank to give us a loan, that manager, you need a five, 15 minute conversation. Somehow you need to do the magic. That person needs to bet on you to get the conversation to the next level. An investor, they need to bet on you. When you're pitching a project, a deck, a slide, you're trying for people to bet on you.
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When people bet on you, you create a movement, action. There's an action. There's a sequence to it, right? That's the patient that didn't know you and suddenly likes you and suddenly starts to ask the right questions. And you see that step by step, that patient is starting to bet on you to the point that they make the big bet.
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but I'm going to choose you as my dentist. That's the big bet for a dentist, right? That's the movement. So it's energy. Because movement, action is energy. So how do you create that energy? So the word movement, I love the word movement, physical movement, but also movement in terms of creating a movement in society. Historically, if you study the biggest movements in humankind history,
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I started to make that correlation between the conversation with the patient, making the patient make the right movement, bet on you, with how do you actually create movements. So people, I started to ask, okay, people say that DSD is not a technique. DSD is a movement. That was probably the biggest compliment.
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For me, when very smart people came to me, Christian, maybe you don't know, but this is not a concept. This is a movement. You created a movement. And I started to ask smart people, what creates a movement? What are the factors that create a movement in society? Because maybe we can learn from that and from this macro big picture meaning that,
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I can translate this to this smaller situation, me and the patient. And by studying the creation of movements in society, you end up realizing that movements are made of three things.
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that you can adapt to every little movement in life. It's not only applied to, you know, I'm not talking about you dentist now, you need to create a movement, change dentistry, change society, you can, but you can learn from the movement creation for every little simple interaction you have daily with your team, with your spouse, with your kids, with your friends, with your partners, and with the patient.
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Getting people to take action. Take action. That means betting on you because they're taking action because they heard something from you. Of course, you need to make them own that decision and feel like they are part of it. It's their decision. That's the art of making people bet on you. But when do people bet on you? Three things need to happen. There's charisma. Charisma.
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You need to find your most charismatic version because people bet on charismatic people. And we need to disconstruct the cliche definition of charisma first. That was going to be my next question. How do you define that? But charisma is number one. And the beauty is that if you study history of humankind, you're going to see that movements were created by all kinds of people.
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our modern definition of charisma, and many that don't follow at all. So there's space for everybody. You don't have to be an extrovert. You don't need to be an extrovert at all. That can play against you sometimes even. So charisma is the first. Cause is the second. The cause needs to be very clear and very beautiful. It needs to be inspiring.
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And the third component of creating a movement and making people bend on you is having the right vehicle, making people see the light at the end of the tunnel. They can see the path. They love your charisma. They love the purpose, the cause that you're bringing to the table. And they see a path moving forward.
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When you combine these three things, you explain absolutely every movement in human history. So when you're talking to a patient, you need to ask yourself, what means being the best charismatic version of yourself in your way, in your style, with your characteristics, not trying to be somebody else?
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then you need to understand that you need to have a bigger cause. That is not just the treatment. That is not just the beautiful outcome. That is not just you succeeding as a dentist. Being a great clinician is mandatory. It is not the cause. If you say my cause is to deliver great dentistry, that's not cool enough. That's not big enough. That's not inspiring enough. What is your cause? The story of
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changing the way people see dentistry and the impact on the last 10 years of your life and making this my flag and my story, that's a cause inspiring enough, right? Or if you have any other cause, think about something that you're a part of that is bigger than yourself, that is bigger than your clinical work, that is bigger than your practice, that is something that you're proud of, that you're part of.
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It can be an association, a project, a research, a collaboration, an idea, a philosophy, something. You need to bring that to the story. Somehow you need to see that new possible patient to see that. That is not about this treatment. Yeah. This treatment is gonna be amazing. But if you patient bet, if you bet on us,
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supporting a much bigger cause. It's like my, obviously we're raising money for Parler at the moment and I'm doing my pitch. I'm getting these investors to bet on me. And it's funny that like the way you frame it, cause it's the same thing with Parler. Like our cause is eradicate plastic from oral care, make people aware of the problem with plastic. That's a cause. And then we have the path
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there with polar as a solution. And you need to use that even talking to patients. You may say, but patients have nothing to do with that. No, but people love investing on good causes. Even if I say yes to this treatment with this dentist, it's not only because he's a good dentist and I'm not gonna be only helping his practice, I'm gonna be helping a cause.
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Well, I think it expresses about you. It shows the individual that you're talking to what you stand for and what you're all about. 100%. And I think with a patient-dentist connection, that's really important. Because if you don't tell them why you're doing what you're doing or what your cause is, they will guess.
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And the likely thing they will guess is he's doing this because he wants to make money out of me. And so I think that's why it's so powerful in that one-on-one situation. Exactly. So that's why you need to find your charismatic, most charismatic version because humans are connected through charisma. And again, there's not one formula. Anybody in this planet
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can become the best, most charismatic version of themselves. Anybody. So there's no excuse. Oh, I was not born with Christian. You speak well or you dress well, or you look okay, or you have the gift. No, no, anybody. It's just, you need to ask yourself, it's a journey. It's an internal journey.
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Dalai Lama is charismatic and is extremely cool. And Einstein, completely different, right? And Simon Sinek. Steve Jobs is the one that comes to mind. Steve Jobs, right? There's some charismatic people that are more traditional, following the traditional definitions, but...
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You have ultra shy people that are extremely charismatic because they found their peace. Being peaceful is probably the number one. Being in peace with who you are is probably the number one, coolest, most charismatic characteristic. And I think that's why treatment plan conversion, one of the reasons that treatment plan conversion increases as people...
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our dentists for over five years, let's say, because they've suddenly unlocked that awareness that actually they can just be themselves. They don't have to be somebody else in the surgery. They can talk as much as possible, and obviously professionally, but as if they were talking to a friend and speak to them in that manner. But sometimes you meet somebody that is 21 that naturally already has that peaceful mindset, right? Yeah.
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So it's not like, okay, I need to work 15 years to achieve that charisma level. No. Of course, we always improve. So the question is to ask yourself and start exploring it, exercising it, practicing it, and finding your power, right? So that's one. Then you bring the cause.
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Because a beautiful cause with an uncharismatic person, it's not gonna fly. People are like, yeah, it sounds good, but people will find an excuse not to follow. With the best, I see that all the time, people that have the most unbelievable cause and work, and I see it's a waste because they're not working on their...
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natural charisma. They're not finding their steady, peaceful inner connection and they're missing the opportunities because people are not following even though the cause is very beautiful. And then the third and final push for people to jump in, invest the money or say as to the treatment is the vehicle.
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Meaning I can, because people want to succeed. I don't want to jump in the cause that is set for failure, right? Even if I love you, a lot of charisma, the cause is beautiful. I don't see the light at the end of the tunnel. I don't see the path. And as a dentist with the patient, we say, oh, the path is the treatment. The path is the treatment plan. That's not what I'm saying.
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the path is not the specific treatment plan of this person. The vehicle is your system to develop great plans. So with a new patient, the question is not, if I'm a smart patient, I'm gonna be trying to see, not if my treatment plan will be great, but what are the systems that this team uses to make all treatment plans great?
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So what do you use to guarantee that your diagnostics, your treatment plan, and your execution is great? Before I even know you, before I open my mouth to you, I don't want to talk about my problems. I don't want to talk about my plan because I'm going to invest time. I don't want to waste my time. So I want to understand what do you do
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to increase the chances that this process is at the highest level possible. What are your systems to diagnose, plan, communicate, and execute to increase the chances of success at the end? And then we can start talking about how you're going to use this amazing system to find out what is my personal path. But what inspires people is to see the system that will help
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increase the chances of success to the biggest amount of people possible. So how does that express itself in a dental surgery with a dentist speaking to their patient for the first time? How do they show the patient that vehicle? So this means that you need to rehearse...
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to yourself, and that's what every great speaker does, right? You practice in your mind the situations and the answers, elegant, beautiful, storytelling, not boring way. If you have one minute, you adapt one minute. If you see opportunity for three minutes, you'd say in three minutes, if you have five minutes, if you have 15 minutes, you have an hour, depends on the situation. If it's a
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social event, if it's a party, if it's somebody that you met at the bar, if it's an elevator conversation, if you're sitting beside somebody on the airplane flying and you see the opportunity, how do you explain what to do in a way that makes people trust the process, right? So you need to ask yourself,
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What is your system? To diagnose, plan, present, and execute. What are the things that makes you and your team unique? The know-how, the technology, the protocols, the workflows. To increase the chances of making better decisions. We use systems to increase the chances because it needs to be a humble message. Because if you say, we always make perfect decisions,
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Decisions, no you don't. So it's a lot of storytelling and communication skills on creating a speech that shows that people want to trust, right? That's why I always like to talk about increasing chances. It's all about probabilities. That shows honesty. That means that if you choose me, there is a chance I'm gonna mess up. Do you want me to lie to you?
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By the way, I have some patients that are not happy with our work. Do you have patients that are not happy with your work? Now, which dentist says that? Starts the conversation with that. Like, now, I'm so confident about the systems that we have because...
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I know the most common mistakes. And I actually, instead of just fixing them, I'm all about creating systems to minimize the chances of them happening again. If a dentist doesn't tell you the truth, I'm telling you the truth. There are chances that things can go wrong. But let me explain to you the systems that we use that minimizes these chances to almost zero. And then you can start listening. Listening.
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So would that be like I'm just using a frame of reference of my own consultation process if I'm explaining to a patient that we're going to do a dental implant and I illustrate to them that we're going to use a 3D printed surgical guide to maximize the predictability of the process? So guided dentistry, great story.
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Digital, 3D digital simulations, making the mistakes on the computer so we don't do in your mouth. Less than 5% of dentists use that. Less than 5% of dentists are using guided dentistry for real. Right? Guided in general, not only implants, right? Mm-hmm. Most dentists believe that they're good enough with their hands that they don't need to guide the procedures. For us, we are the best with our hands, but we still do guide it.
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because it increases predictability even more. We commit to the plan, meaning that we make outcomes more similar to plans. So modern dentists love respecting the plan. Whatever we show on the computer doesn't guarantee an outcome but increases the probabilities of that outcome. That's why we use technology. We are among the best without technology. With technology, we are even better.
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That's the truth of technology. We use collaboration with companies and planning centers to leverage collective intelligence and artificial intelligence to make every simple decision slightly better. We focus decisions on the impact on your life, on the last 10 years of your life. So you can be guaranteed that what we decide today is not only about looking better tomorrow or next year,
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It's about thinking forward because this collaboration, I hope, will be forever. I don't expect just to treat you this time. I hope that you're going to love us and this collaboration so much that you're going to stay with us forever. And we're going to be able to take care of you forever. So my decisions are different than most dentists that are thinking about the treatment. We are thinking about 60 years ahead of us. And that is true.
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right? That's why we focus on technology that helps us replicate quality and quality control. That's another concept that dentists don't use. We quality control the outcomes. So every time we are slightly better, let me explain how we do that. Very simple, right? So we use 3D technology to quality control the outcome.
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of our procedures, and then we have systems in place, not only to fix things if they are not good, but to evaluate why it was not ideal and how to avoid the problem next time. Nobody talks about that in dentistry. No.
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It's about processing the quality control procedure, not only to fix this case, but to avoid the chances or minimize the chances of repeating this next time. Nobody talks about that in dentistry. No, I mean, that's very much black box thinking from Matthew Sire. Exactly. How the airplane industry have continued to improve. 100%. They're very open with their failures. They're not a blame culture.
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We have a problem. Plane is going to fall. We need to do whatever we can to save that plane. But once we save that plane, we stop everything. Okay. Congratulations. We saved it. That's what we do in dentistry. We are every day saving the case. We stop. Say, okay.
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First of all, there was an issue and we brilliantly solved the issue. By the way, dentists, good dentists and good technicians are amazing solving issues. We are amazed because we are trained for that. There's a problem on the fly. We solve it. What we don't do is to after we solve it, after the celebration, after the patient is happy enough, we stop. We go back. See, that issue happened. That's it.
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why it happened. And we go backwards. And then we start to analyze all the things that can be improved to minimize the chances of that same problem happening again. We don't do that in dentistry. And we repeat, repeat. And we become so good fixing problems that solving the actual source of the problem doesn't become a priority.
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Yeah, we just constantly live in a problem-solving environment. So this final speech here, if you see a patient that is very analytical and you explain this to the patient, you make this patient a fan in five minutes immediately. Immediately. So there's another component that is reading the patient.
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understanding the patient's character because one story that sticks to one person is different than the story that will stick to another person. So you need to become a master communicator. That means you need to adapt your story to the person that is sitting in front of you. And that's an art. Is it the same cause, just framed in a different light for the specific nature of that patient? Exactly. Like the way... Because...
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Your cause and your system has many highlights. It's a combination of so many great things. You need to pick the stories and the points that will create the most impact on the person that is sitting in front of you. The things that they will value the most.
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Right? And every personality value is a different thing. Mm-hmm. So, first appointment, second appointment, you need to listen. You need to make like a psychological x-ray screening of the person and be very fast understanding what makes sense to that person and how to connect your strengths to what makes sense to the person. Mm-hmm. What stories are you going to pick from your toolbox? Right? And...
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and point that out because you don't have three hours, you have 10 minutes. Yeah. And I think on the quality control point, I think with the way that AI is going,
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it's going to be more and more important that we quality control ourselves internally before our patients start quality controlling us themselves, utilizing AI. I mean, it's going to be only a matter of time before they start requesting their intraoral scans before and after as part of the treatment planning, or as part of the post-treatment process. And comparing. Especially if things have gone wrong.
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So I think we're going to need, maybe we've not had enough of a push as a profession, because we've been so good at solving problems, to actually do that homework. But actually... We need to push the company because the tools are there. Yeah. For many, many things to already be happening in terms of effectiveness, consistency, the airplane industry philosophy, right? The problem is that if you make a mistake in the airplane industry, you kill 300 people in one shot.
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We make huge mistakes, we kill nobody, right? So we get on our comfort zone. But if we start thinking about the impact on the last 10 years of somebody's life, that gives a bigger meaning for the decisions that we make today. And we need to push the industry to help us with that as well. I want to understand what are the recurring mistakes.
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and how to minimize the chances of them happening. How many, example, how many times you try in anterior crowns and the black triangle is slightly too open or slightly too close. And you have to send back the case to the lab and say, look, open a little, close a little bit. Because the patient's like, I don't like that black thing.
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That's just one of millions of little mistakes that a restorative dentist has to face, right? Limitations will drastically impact the satisfaction of the patient, the experience, rescheduling, waste of time and money for the patient and for the dentist. And the technician. And the technician. And we fix the problem.
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and we continue our lives. And we black box thinking is like, okay, can we eliminate this mistake? Eliminate, probably not, but can we minimize? If it happens three times out of 10, can I bring it down to one time out of 10? How amazing that will be. How amazing that will be. So you need to ask the question, why the black triangle is too open? Why the technician didn't close it more?
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Was it because it didn't have the soft tissue information? Doesn't have the morphological know-how? It didn't have... The prep was not allowing to close the space. Why we didn't see this problem coming before? Why we didn't see this on the provisional? Why we didn't see this on the mock-up? Why we didn't see this on the digital screen? Because the technician shared the link with me. I saw the restoration design. I approved the restoration design.
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The technician took pictures of the ceramics, shared with me. I said, okay, you can ship it. They shipped the case. I scheduled, I confirmed the patient. The patient drove all the way from the other side of town. I removed the provisional. I placed the ceramics. It took us one hour to get to this point after one year of treatment. And now I see the problem. Mm-hmm.
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This is the worst moment. This is the most expensive moment to identify a mistake in restorative dentistry when we are trying in the restoration. And I can guarantee to you that two-thirds of the problems that we identify on the try-in phase could be identified before the try-in phase. Good thing.
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In my opinion, two-thirds of all the mistakes that we identify on the trying phase could be identified before the trying phase. By the clinician, by the technician, or both? Both. Both. It's reverse engineering quality control, right? And I started to develop content on that because as a technician, I was tired of
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fixing the same problems over and over again. And if we make a mistake, we don't kill 300 people, but financially speaking,
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it has a huge impact if we start solving these problems. And if we start pushing companies to start developing solutions for us in terms of quality control and systematic review of mistakes, reverse engineering solutions to avoid mistakes, asking the questions, for example, about the black triangle. What are the things that we can do?
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when we identify the potential. First, how do we identify a potential of a possible black triangle in between teeth? That's the first step. So it's highlighted since the beginning for dentists and technicians. This is a case that we will probably prep in a few weeks or still we're going to do ortho or still going to do surgery or we're still going to place implant. But we already know that here, here, and here, there's a potential. So every decision starts to
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Try to minimize that, right? That impacts the way we do the ortho. That impacts the way we place the implant. That impacts the way we do period procedures. So we are consciously understanding how to minimize that issue. Then the way we prep teeth, huge, as we know the relationship between finishing line and closing the black triangles. Then discussing dentist technician about the information that you want to share with the lab.
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And how can you play safe with the design to minimize the chances of having to ship back the restorations, right? What are the things that you can solve chair-side, right? And what are the things that you cannot solve chair-side? And how can the technician minimize that chance by understanding that and changing the design? And then how can you do the quality control of the design by just...
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You know, we have so many things to check. That's the black box thinking, right? It doesn't matter how experienced you are. There's so many things we need to check that we cannot rely in our memory, in our eyes. We need checklists. And we need to be disciplined about it. So when I share a design with you, dentist, if you don't use a checklist, you're going to miss points. And then I'm going to manufacture it.
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And then we're going to lose a lot of time and money. So why don't we, you know, invest a few precious minutes now because we are always in a rush. That's the thing about the airplane industry. There's no rush. I'm flying a lot and I'm so many times so angry with delays. And I see the pilot and he's going through the paper. Yeah, yeah. They're not taking off unless they've had it checked. And then they see the guy with the paper leaving.
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And he's like, look, then he announces we need to wait 20 more minutes because the paper needs to go to somewhere. Somebody needs to sign. And I'm like, damn it. And then I stop and I say that I shouldn't be complaining. Yeah. Right? I should appreciate this. Thank God there's no skipping steps. Mm-hmm.
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There's no bending corners and that's it. Now, in hospitals, they have that more, right? There's a process. You cannot jump even though you're 99% sure to go this way, you don't skip the step. In dentistry, we are completely amateurs on this regard. We are completely amateurs on evaluating a mistake
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and then developing the systems to avoid that mistake next time. And I believe that's a department that companies can help us a lot. AI can help us a lot. I was going to say, yeah, you think AI will help in that space? 100%. But we need to push the industry to develop the tools.
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Well, Christian, I think we're going to have to call it a day there. I think we've been going for a good couple of hours and I've barely touched the surface of the topics that I wanted to talk to you about. So we'll have to get you back for a round two next time you're in town. Or maybe Madrid next time. Yeah, I'm always here. So it will be a pleasure to come back. I'd like to finish with just your sort of one thing that you're most excited about for the next decade of dentistry. What do you think is going to have the biggest impact
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with as much specificity as you can do. I mean, obviously we all know AI is going to change things significantly, but what do you think is going to have the biggest impact? Maybe towards getting towards that. I'm going to call it lifelong dentistry or lifetime dentistry that you've defined longevity dentistry or just dentistry or just the right dentistry, the right dentistry. Um,
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So two things that I hope will become the biggest trends. One is the super diagnostician topic. Leveraging technology for that, but...
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really connecting with the idea of the oral physician, the oral physician exploration. The exploration phase for me, the reinvention of the first appointment. And this is all based on this partnership for life. As soon as we embrace this idea of a partnership for life, all decisions, we change our perspective on decisions, right? Right?
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So this is one field and we can leverage technology. We will leverage technology. AI is going to help, but it's a personal decision. It requires a lot of human skills to become a super diagnostician, an oral physician, the big picture person, the relationship person, the doctor for life.
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If you just want to be a cosmetic dentist, no judgment, but be honest with it. Don't tell people that you are a healthcare provider because you're not. You are just a cosmetic professional. You're on the team of plastic surgeons and hairdressers and cosmeticians and this. No, and no judgment, right?
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that's all you do and you're amazing at it, fantastic. There's space for everybody. But you're not a neurophysician. That's one thing. The other thing is at the end, restorative aesthetic dentistry, the three-star Michelin dentist. If you wanna be protected by, if you wanna be resilient to all technologies
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If you want to succeed into the future, make the decision of becoming the three-star Michelin restorative dentist. And that has very little to do with technology because everybody's gonna leverage technology. Technology is gonna become a commodity. Knowing how to use technology is gonna become the normal.
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And technology is going to level the field in a good way, guaranteeing a minimum quality in some procedures. That's good. So that's not going to be the differentiation like it is today. That is cool being in digital dentistry. It's not going to be cool anymore. It's going to be normal. So it's going to be all about the three-star Michelin dentist, the dentist that I would do my 10 veneers myself with if I need it.
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is the dentist that is a master on the art of human skills. Human perception, human connection, human artistic interpretation, human hand skills, human relationship. If I'm gonna do
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10 veneers on myself, or if one day anybody that I love needs a better smile, if it's veneers or a full mouth rehabilitation, if anybody in the future that I love needs a better smile, I want to find a dentist that has these human skills. And there are a lot of room at the top.
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Being a three-star Michelin chef, once you are there, there's scarcity there. And dentistry will be extremely generous with you, and you're going to have a great life. Love it. So the artist and the diagnostician, those are the two bets for the future. Super diagnostician and amazing human artist.
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Lots of positivity for humanity then in our profession moving forward. Dentistry is very resilient in terms of being substituted by technology.
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Yeah. Brilliant. Well, Christian, thank you so much for that. It was a very wide ranging and thoroughly enjoyable conversation. And I look forward to having you back on sometime soon. My pleasure. Cheers. So thanks for making it all the way to the end, guys. I hope this episode really gave you a lot of value. If you did enjoy it, then please do share it with your colleagues and hit the subscribe button and like below to help us get bigger guests, bigger value and really help build this community.