12 Rules for Dentistry – IC002

[Jaz]
David Bretton. Mr. Positivity?

[David]
Jaz, Good to be here.

[Jaz]
Absolutely. And I when I thought, right, I want to do something like 12 rules for dentistry because, obviously the book by Jordan Peterson, and a lot of other industries and professions have sort of made their own 12 rules if you’d like. And I thought, right, if I do something like this, there’s only one person in the world I can think of who would match it so and who will do it justice. And that’s, you

[David]
I appreciate that. I didn’t know it’s your may have connected me since on the sorts of topics I think, really, we’ve always talked about things beyond the clinical side of things of dentistry.

[Jaz]
That’s right. Remember the first time we met and we discovered our mutual interest for self development and positivity and that sort of stuff? Do you ever do remember?

[David]
It was [inaudible] award?

[Jaz]
It was. It was British and ronix. And it was actually you introduced me to Tony Robbins. Yeah. That’s quite life changing. If you’re the one who introduces someone to Tony Robbins, you’ve changed someone’s life for the better.

[David]
You’ve definitely helped people to that, I’d say we’ve definitely people.

[Jaz]
Awesome. So let’s just dive right in.

[David]
Dive right in, so about 12, our big rules to go for I think so. Yeah, let’s get on a chat about that really.

[Jaz]
Absolutely and for those tuning in, and thanks for joining us, you know, these 12 rules are what we make it, have your own 12 rules. It’s you know, you might enjoy some of them. You might hate some of them. That’s completely cool. Okay? Weird is this something that me and David sort of looked at and agreed on that? You know, actually, and there might be some things that we haven’t actually rehearsed this. So there might be some things and I said today Look, it’s completely cool if we disagree on something. So let’s go. So rule number one for rules in a 12 rules for dentistry or 12 rule for dentists or everyone involved in dentistry is see everyone. So David, I came up, well I didn’t come up with this rule. I pinched this rule from a book that’s called If I could just tell you one thing by Richard Reed, have you read that one?

[David]
I haven’t. No.

[Jaz]
So Richard Reed, he he’s basically meets all these powerful people in the world. And he just answered one piece of advice. And what Bill Clinton said was See everyone. And what that means is basically that Bill Clinton, he has a very special talent, or a gift is that he makes everyone feel important from the person who opens a door for him, from the taxi driver, from you know, big or small, whatever, he will make a child, an elderly person, he will make everyone feel seen. And he will make everyone feel important, which I think is so beautiful. And the way I apply that at dentistry is sometimes you know, when you’re having a bad day, a rough night’s sleep, and you go into work, and the nurse knocks on the door, Knock knock, opens the door and says yeah, ‘Good morning, Jaz.’ And you know, what if I’m, if I’m on my computer, and I go ‘morning’, and I don’t even tend to look around, that’s not doing it justice. So to basically make that eye contact, make that smile, make someone feel important, make everyone feel important.

[David]
Me, I think, can’t know enough to be said to how much of a team thing dentistry is. And you know, you see your nurse in particular more than you’d see your other half. You know, you’re with them all day in [Jaz] work wife. [David] `Yeah, work life. Absolutely. And I think to make them feel appreciated, and some nurses definitely aren’t paid and appreciated some time, which is a whole different topic. And as an associate, you know, it’s a stranger. So I think beyond that, to make them actually feel appreciated and cared for. But as you say, you go well beyond that. And that’s to the cleaner to the, you know, everyone else you’re going to see in the building. And I think

[Jaz]
Just the other day, we will in for a Christmas party. And I’ll use the term as odd the cleaner. Okay, she was, we didn’t need to lock up. So we all said, Oh, yeah, the cleaners say we don’t lock up with the cleaners right there. And yeah, I said, hang on a minute. And I looked at and I said, What’s your name? Her name’s Evelina. Okay, no one, no one knew her name. So now we said, okay, Evelina’s here. She’s gonna lock up. So she’s not the cleaner anymore. She’s Evelina. totally right. Even now, the cleaner no matter who you are, we as in our profession, for positivity. For all these reasons for just life, we need to see everyone and even that sometimes the person who’s accompanying the patient, or the people sat in the waiting room, when you’re going down to collect a patient or go into the waiting room, collect patient, say, Good morning, smile at everyone, make everyone feel at ease, and then collect your patient. That’s completely cool.

[David]
I’ll tell you why that’s a big one, you know, when you have patients who, for example, don’t speak English, and you have a translator. And what’s really strange that people do is will speak to the translator and sort of actually don’t speak to the patient anymore, you know, is having this dialogue with because you tried to communicate with both. And I think, you know, it’s a massive one and I think on the topic of speaking to our patients and definitely seen our patients. What I always think about our patients is throws the dentist we have, we might have, you know, 20 exams in a day, for example. And each of those is just your, you know, if you want to look at like this, it could be your 11 o’clock exam. But to that patient, you are their one dentist, and you know, they are only going to be seeing you once every six months to a year. So if you have one bad encounter with them, you’re probably going to forget about it, whereas they’re not, you know, that’s like a big thing for them, it says the dentist about this bad experience. And it was a 15 minute exam. And you could have just read through relationship because of that, really. So I think it’s important to realize that, you know, these are big events that people sometimes comes for a tooth out, it might be a third tooth that had out. To you, it’s just another tooth that you’re gonna take out and to them, it’s like sometimes a really big life moments

[Jaz]
It’s a big deal. It’s a big deal, which leads us nicely to rule number two, Dave. So lead the way with Rule number two,

[David]
Rule number two, me and Jaz decided that was create a positive environment. So rule number two, create a positive environment. Now this goes, you know, beyond dentistry, it’s again, it’s just a whole life concept, I think creating a positive environment. And, you know, like Jaz said, we’ve got to see everyone. And that’s all about the environment that you’re in, the people that you work around. And I think really, you know, if you’re in a negative toxic environment, then sometimes is goodwill as you can be, doesn’t matter what books you read in and you know, how you’re trying to fire yourself up, I think you are going to go into work and be sucked down, you’re going to have that energy sucked out of you. And about each other. I go on courses and meet certain dentists and certain practices. And you can just tell that had the life sucked out of them. And I think some big corporates, again, a name, and they’ve had this tarnish to them a little bit I think that sort of feeling where actually people didn’t feel like they were in a positive environment.

[Jaz]
But where I see that the most, and where it’s evident for everyone is when we go on these, you know, on the Facebook groups, okay? And it’s so important, I think to sort of make your mind like a sieve. If you detect the tone of a post is really quite negative, and the usual politics, you know, I just skip past it. I’m so much happier for it. It’s like in some of the books that you read, like some of the some key people in the world CEOs, one, one piece of advice they give is don’t watch the news. It’s similar when I applied debtistry is that, you know, I only really engaged in posts that are uplifting or positive or important. Sometimes, you know, things can be a bit down, but they’re important and we must engage. But anything that’s just got a undertone or

[Jaz]
Yeah, gossipy drivel. I mean, that’s the problem. Social media has become this extension, from, you know, you’ve had a bad day, you’ve got a few things, And I was criticized a while ago for blocking and delete in loads of people on Facebook. Why not? Like, what why would I just for the sake of, you know, not getting? Why did I feel like I have to have all these people on my Facebook?

[Jaz]
Absolutely not. And, you know, I commend you, that’s the right thing to do. And the same way, you know, the part of creating a positive environment is filter out negative people, negative experiences, negative vibes. So that totally goes hand in hand.

[David]
Yeah, and on the other tone, if I ever made someone, you know, I had someone delete me quite a while ago. And then they messaged me saying, sorry about deleting you, you just kept posting really positive things. And I was in a really bad place. And it was making me feel worse. And, you know, fair enough. I wasn’t feel bad by that and just felt well, you know, if that’s what made you feel better, then yeah, block, delete me. And you’ve got to do what’s working for you, I think, and create that environment around you, that’s going to make you feel better, or do what you need to do.

[Jaz]
If you adopt a mindset that everything around you is collapsing, it will be. So you’ve got to adopt that mindset, and that, you know, create the positive environment. And that’s, you know, in all manners, be it your online environment, your physical environment. So that’s a great piece of advice.

[David]
And I think, you know, that’s why I know for you and me, the environment we have in our home lives, it’s just in like I said, just as important. We’re having to nurture this positive environment around us, our family, people support in you, it means so much, I think good thing to just end on this is a quote that I just love, I think, you know, it says that, you know, when a flower doesn’t bloom, you fix the environment in which it grows, not the flower, and I think so often, a dentist we try and think we’ve got to fix ourselves, but actually it might fixing the environment you’re in, and ensuring that you’re in a positive supportive environment.

[Jaz]
Beautiful. So dentists and anyone connected dentistry out there you are the flower, nurture your environment. So rule number three, the patient in front of you is the most important person ever when they’re in front of you. So sometimes you’ve had a bad sort of week, bad day, you might have had an argument with someone important in your life, you might have not slept very well, you might have a flat tire, you have to forget about everything when that patient’s infront of you, you cannot have anything in your mind, a voice that’s distracting you, you can’t be thinking about the ashes, the World Cup, you can’t be thinking about the general election. When that patient’s in front of you. You need to give them your everything. And they’re our most important things. And someone who echoed this recently was Finlay Sutton, is at the Tubules Congress. And he said, is that really resonated with me, I think, yeah, make that person, you have to forget about everything for that patient.

[David]
I mean, I think it’s just, we’ve almost already said it in terms of, you know, like I said, this person is coming to you. And it’s such a big event for them. And as was said, if you’re not then making them the most important person, then you really doing yourself a disservice as well as the patient, I think, because they’re going to go away and not feel that you’ve had the right positive impact on them. And I think

[Jaz]
At some patient acceptance or treatment as well, you know, we have talked about that it’s important.

[David]
I mean, you know, I think this is one of the things that really riles me and bugs me and as much as I think things like Instagram aggress. I think what’s happening with dentistry now is a section of dentists almost to, actually, it’s no longer about the patient’s best interest, it’s no longer about the person what’s in the best interest and what’s right for that patient, it’s what’s gonna look best on a photograph, what’s gonna look best on their Instagram feed? And for me, it’s everything that’s wrong about dentistry at the minute, it’s this ego driven and I need a good before and after photo. Is that the right thing for the patient? Did the patient care about the gold crown on the Upper premolar that you want to replace just because it’s going to look better on your photograph? I don’t think so. And so, you know, I think that’s a big thing in dentistry at the minute. And I think some people’s whole workflow almost is driven by what’s going to look good, talking to other dentist and showing other dentists. And actually, we need to remember that it is all about that patient. And, you know, if they’re happy with that big amalgam on that tooth, and they understand that it may fracture, they understand the risks and problems and consequences. If they’re happy with it.

[Jaz]
It’s okay to compromise sometimes in all things being balanced, it’s okay to compromise sometimes for the best interest of the patient.

[David]
Absolutely. As long as you had. And like I said, best interest because as long as you have had that discussion, and you discussed and given them options about these things, it’s ultimately about them. And that care not about what is textbook, right or

[Jaz]
what not, I’m gonna pay you a massive compliment. What you just said is literally most almost like so similar to what Tif Qureshi said, in my recent episode, when we talk about dahl and stuff, you’ve literally said the exact same thing. So that’s my massive compliment to the fact that you’re in synchrony with Tif Qureshi.

[David]
Do you know every time Tif post something, I’m just like, even in WhatsApp about the the recent politics. Everything Tif ever says everything I’m just like, Yeah, I agree. I agree with that Tif, because honestly, like, say, is a massive compliment to be. But it is. It’s what it’s all about. And I think as soon as we realize that, and I think it’s when people talk about Don’t think about the money, the money will come. You know what just like to have them, if you put the patient’s interests first and tell them about things, give them the options. Yeah, the treatment will come, the money will come. And I’m finding that that’s that for myself, you know. And, you know, as we’ve both done, we both have skilled endodontic skills. But if I see a tooth and it has no area, sub optimal root filling, I’ll just discuss we can redo it. There’s pros and cons, always. And it’s never the most important. And now I think it’s a really important rule. And, you know, it’s funny how some of our rules can have as much criticism as things like the general dental council get as many of our rules actually when you look to the core of it, what the general dental council would want us to do, you know, put patient’s interests first, we like to make patient the most important person it is.

[Jaz]
Rule number four.

[David]
Rule number four. {Jaz] massive one [David] it comes on just from that last one. Rule number four, don’t own the patient’s problems. You know, when you may sit down to look at these 12 rules, as we were really conscious, I think and focus to make it about 12 rules to have a happy and relaxed and stress free life in dentistry. It wasn’t just about how to be clinically the best dentists and it’s so much beyond that.

[Jaz]
And then there are those rules out there already know how to get loupes, get magnification. That’s been done, this has got a different twist to it.

[David]
100%, actually this is bigger, this is more about whatever you’re doing, all these rules can be applied. So don’t on the patient’s problems, I think my experience is one of the reasons that dentists are so stressed is that they own the patient’s problems, they carry the patient’s problems around with them, the biggest ones, you know, deep filings, the patients come in, they’ve got massive, massive, massive caries in a tooth. And the dentists are all stressed about this might flare up. That’s not your fault. That’s not your problem. It’s only your fault. If you’ve been seeing the patient for years and years and years and years and years not taking some x rays. If the patients presented to you as a new patient, and you see a huge hole, you just have a conversation that this is their [inaudible] not yours. And you know, I work half a day a week at a dental hospital with undergraduates. And I see this all the time. I see this all the time, you know, they just own all of their patients’ problems, you know, “oh, boy, he’s got really loose teeth. And like, you just, like, you take an X ray, and you just go do the things you got to do. You got to take an X ray, tell them about the problems and make them own their problems. So if someone has a deep filling, you say it to them, “Look, I’ve taken this x ray, this is what we can see. And as a result of this, this is what we, this is what’s going to happen, you know, we can do our best to try and do a filling, however, there is a risk that it flares up. In fact, that’s very high, because this is the x ray, you just communicate and communication obviously, is so important. But that’s not our problem. It’s our patient’s. Similarly, with bone loss, you’re going to let people know about it.

[Jaz]
That has I mean, that affected me a lot in my first three years in clinical practice

[David]
Oh, absolutely. Couldn’t agree more. And I think they’re the people that does affect the most, young dentists too, who just carry all their patient’s problems around with them. Because as well, you know, you go from a hospital environment as an undergrad where people aren’t paying. So reality is what happens in that environment is everyone gets what the told to get, you know, you said to a patient come back for multiple cleaning appointments. [Jaz] They’re cerainly not listening [David] Yeah, you know, that’s how it’s gonna be. The difference is when you’re going to pay in into practice is that what happens there is suddenly compromises have to come. Because suddenly, if I’m charging 500 pounds for a root canal filling, that patient needs to know, at that appointment, “Look, this is what’s going to could happen, and this is what’s going to cost you” and that patient may then be saying “well, I’ll look out for that.” That’s not your problem. That’s not you who should be carrying that problem around with them. And I think we you know, we both probably found that we’re things like tooth wear. Tooth wear is complex, it’s expensive to treat. And all we can do is tell people about it and not on that as a problem now I feel this is where I struggled in national, in NHS practice, I really struggled in NHS practice because you know, the final straw for me I just practice, when a girl who came to me and I’ve already done about three root canal fillings for the band to charge so you know what we’re talking 10 pounder root canal so they’re not even

[Jaz]
And you spent hours

[David]
Hours good quality, your root canals a good quality and we don’t want to and if you’re not the central and it was retreated, massively build up with composite and it fractured. And she said to me, you know fractured at gingival level. And I was like it’s broken, these are options, bridge not really an option because the neighboring teeth just weren’t suitable, an implant which is the ideal, the gold standard option here, not going to damage any of the teeth it’s going to be the ideal or a denture, and we do her a denture because that’s what she wanted. She was an NHS exempt patient, we did her a denture and it wasn’t good enough for her and, you know, it didn’t match how the teeth next to it looked. A upper central denture. And, you know, for me what happens to the NHS is you are made to earn the patient’s problems sometimes, they come in ‘your my NHS dentist, what are you going to do about this?’ And what I find for me in private practice is that patient can come in, and they can go and see any dentist they want. So I don’t have to own their problems. I’m just here as someone who can offer them some solutions. And if they say, well, so and so down the road that he can do this, great, go and see so and so down the road, I am obviously not as good as he is. And I think since I stopped owning the patient’s problems, since I just started stepping back, telling people what I saw, giving them the options, and a hell of a lot less stressed. You know,

[Jaz]
This is a massive one, this right here is probably I think this is my favorite rule, what we’re discussing right here, because affects so many people, and if for my mental health, and my cortisol levels, this has been the real game changer. I know the word game changers use banded around. But this really was such a massive thing. So if you’re listening out there, and you’re owning the patient’s problems, and then I’ll expose myself a little bit, in my earlier years, I’m a highly empathetic individual. So when I remove a tooth from someone, as a DF1, I’d go home and about to go to sleep. And I’m thinking, ‘I hope that patient’s Okay, I hope they don’t get a dry socket, I hope they’re not in too much pain right now,’ which is a beautiful thing in a way to be so empathetic, but in a way that is going, it’s a bit too much for people to affect my personal life and my emotional health. So I know some people who do that, you know, young dentist do this. And it’s a very deep conversation with have. So I think don’t own the patient’s problem. And then this leads beautifully on to rule five [David] absolutely respond go ahead, Jaz [Jaz] which is Don’t care about a patient’s teeth more than they do, just absolutely do not do it. Because you’ve had those situations where you’re again, owning the patient’s problem, you’re stressing about it, and the patient as led themselves or you know, through negligence or neglecting themselves into this path. And they’re not that bothered. So why should you be?

[David]
That absolutely I mean, this is, I think, where we really struggle, because we value as dentists we value oral health. So highly, we value it so high, we think it’s like it’s our lives, you know, teeth are everything. Oh my god, how could someone lose an upper central tooth, I have sat and had conversations with someone said, Look, this tooth really broken down. These are your options, we can take it out and look at replacement options. Or we can try and say there are all costs. And patients who just turned around and said, Oh, just check it out. And I’m like

[Jaz]
It shocks the system, isn’t it? It shocked to system.

[David]
And so I’m like, ‘so what we’re gonna replace it with?’ And they’re like, ‘honestly,leave the gap.’ And I was like ‘what?’ Some people do not care. And some people do not care because they just don’t value oral health. Some people do not care because they might have other things going on in their lives. You know. And I think again, reducing stress for people, for dentists, I think, it’s again, such an important rule don’t care about patient’s teeth more than they do.

[Jaz]
I think you summarized it quite beautifully with that. We made it very tangible without central incisor I know we’ve all had patients who for us to have that same issue in our mouth, it’d be the end of the world. But they don’t seem bothered by it. So you shouldn’t, you know, have those feelings in yourself. And that’s another important step to being more fulfilled and happy.

[David]
Absolutely. And I think, you know, I saw this a lot with gum disease, a lot with periodontal disease. I tell people, I worked in a very, I worked in Yorkshire, as you know, you graduated there. And it was a very, very, very like, it was a affluent area, both very sort of, a lot of the men in particular had a lot of tooth wear and a lot of Perio and didn’t care and every conversation and it was frustrating because he kept coming to have the same conversations. And they would just say, ‘Well, can you just give me one of those little cleans?’ And I was like, and you know what? I got to the point where it’s like, ‘well, yeah, I can, but as long as you understand that that’s not the ideal thing. And eventually you may you may lose some teeth’ ‘Oh, that’s fine.’ Just crap. And that was it. And I was wanting to do six point pocket charts and multiple perio treatment appointments. They didn’t want to do that. They didn’t care.

[Jaz]
Right example because people always posting on there that Oh, I’ve tried Vaughn surgical root service, and the patient comes back and it obviously not using tepe and not so brushing. That’s an example of someone who doesn’t care. So why should you? You just had to use the minimum standard and advise but there’s really not much more you can do

[David]
No, absolutely not. And that’s why I was really happy recently when the perio guidance all changed. I was like, finally, thank god a little bit of common sense that actually, Hey, you know what, someone’s got a lot of inflammation, you’re giving them a toothbrush, you getting rid of some of the big deposits and sending them away till they start using it. And, you know, again, it’s something I think we struggle with, in particularly young dentists, when they just graduated. They’re coming out all keen, and threw all the gold standard treatment, I need to do a six point pocket right here, I need to do this year, I need to do that here. And here, you’re going to see some people and they just got ridiculously high caries risk, doesn’t matter what you do, they’re going to come back with new caries lesions every three months. And if they don’t care, why should you? Why should you spend hours trying to do these restorations that you saw on Instagram? Just restore the caries. And honestly, I just think people sometimes they literally we do, we care more about our patient’s teeth and some patients do. And I think at the same end, I think when we have patients who have extremely high expectations, and they care about something very minor, we should still care. Because on the topic of you know, don’t care about patient’s teeth, they do. If they really care about them, then we should, I think respect that. And we should care just as much [Jaz] Beautiful. I loved that [David] As the people who come in who said, ‘I really don’t like and it’s something really minor’ and I just say ‘Have you not discussed it with your dentist?’ and they say ‘Yeah,’ he said it’s fine.’ And I’m like, ‘Does it bother you?’ ‘Yeah, it bothers me.’ ‘So why we don’t discussing options for you?’

[Jaz]
It bothers them, they’re the most important person once again,

[David]
I said, we’ve got a huge spectrum, and some people don’t care. So we shouldn’t care about their teeth, we should still give them all the options and et cetera, et cetera. But when we have those patients with ridiculously high expectations, and they care a lot, we should honor that and respect it and head, you know, what, if someone’s got good ones, in all the Sexton for the BPA, and they really care about their oral health, we should be looking to see how we get to them to all zeros.

[Jaz]
Beautiful. That’s so true.

[David]
Why are we not talking to those patients about tepe brushes? When they’re not using them? They’ve already got an electric toothbrush. And you know, I think especially if you’re busy general dentist, does that worry that someone like that comes in and they’re just like, ‘Oh fine, someone with not doesn’t need anything, see you in six months,’ and no, everyone we should be, like we said, we should be treating everyone as the most important person is their expectations are high. And they they demand a lot from themselves, if they’ve got the slightest thing that we detect some minor tooth wear, a little bit of bleeding, we should tell them about it. And we should take them to that next level. I think.

[Jaz]
A beautifully said and that leads on again, beautifully to rule number six, which is on the topic of ultra high demanding patients, if you like is Trust your gut. Now we all have that patient where we regret taking this case on and maybe you took it on because you wanted the experience. Or you wanted to do a specific type of case, or you generally want to help someone, but you really did not undersell, and you really found it difficult to over deliver in that case, because the expectations are sky high. So sometimes you get that feeling that really sick feeling in your gut before your, even during a new patient consult that actually ‘am I sure I want to do this. There’s something quite fishy about it.’ I mean, do you have that feeling? Right? You get that gut feeling as well. Right?

[David]
100% You know, it’s funny, because you talked about Tif Qureshi before and just to bring it back onto Tif Qureshi obviously, he advocates a lot of ortho, GDP-ortho for his patients, don’t even assess wear. And what Tif talks about quite a lot recently is how a lot of young dentists are going looking for these Instagram patients. Or let me do some marketing. Let me pull in some new patient. And actually what a lot of people are doing is they’re ignoring those regular, everyday patients that they’re seeing in their practice. They are the safe people that you know, you build a rapport with, you’ve got this relationship with. And actually, you’ve already got that gut feeling and everything else is usually fine. I see you know, when we do bring the patients in from places like Instagram, it’s never been more important to trust you go and sometimes you just get these vibes of people and they’re just never worth it. It doesn’t matter how much you’re going to charge. They’re never worth treating and because you’re constantly then see their name that you booked and if you just think we should never touch them.

[Jaz]
Don’t treat someone that you can’t have a laugh with. On that same vein.

[David]
Yeah, absolutely. Someone who you are never going to be in rapport with and it makes it really difficult. I think if you can sort of cool to the A patient best who seems like you think you will just have the easiest time because you’ll be in

[Jaz]
You will have such a great career. [overlaping conversation] [David]
Absolutely, you’re going to love you do. [inaudible] in a positive breath for Instagram denies the benefit. When you do your own marketing, you will attract the patients that you want to treat who are like you. It’s why on my Instagram, I’ve always had my personal life, hey, I get patients coming in? Well, I came to see you because you’ve got a Dalmatian, I’ve got a Dalmatian. It’s bizarre, but it’s why I sometimes think it’s hard to separate your dental life from your personal life, [Jaz] it shouldn’t have to be the case [David] absolutely not an issue. And similarly, if you want to showcase what you do, and you want to market, make sure you’re very genuine with that. So you’re marketing, what you’re actually about. Because otherwise, you’re gonna attract people who you actually don’t want to treat, you don’t want to treat those people. And I think trusting your gut. And one thing that we can never overlook is just like you said, is the patient attached to their teeth? So what we see on on things like Facebook, it’s a little case and say, Oh, you know, I do some teaching with Invisalign, and some will bring a case along, and they’ll say to you, ‘Do you think I can treat it? and you’ll go through all the dental side of it. And fundamentally, you think, ‘I can’t tell you what it’s treating patients, because I’ve never met a patient.’ And that can be the make or break whether you should treat them.

[Jaz]
You don’t know what the goals are, I think ultimately you hinges on the patient’s goals.

[David]
Absolutely. And it hinges on what they are expecting, do they want the very best, and if you can’t provide that or in any doubt, then No, you don’t want to treat that, you know.

[Jaz]
So everyone trust your gut when you have that sinking feeling you’ll never regret not seeing a patient. It’s what the basic what we’re trying to get to. So

[David]
You can’t remember the ones you never treated ever.

[Jaz]
Exactly. So that’s the first half of rules done now complete switch. Day take away the next two rules, quite nice ones.

[David]
Yeah, so an extra rules. I think the first ones all seemed more focused on the patient. And that interaction between dentist and patient, I think other rules are more focused on you as an individual, as a dentist. Rule seven, take time to take care of yourself. And, you know, we talked a little bit about Jordan Peterson’s book, this is what kind of inspired us to sit and write 12 rules. And you know, Jordan Peterson said in his book and one of his rules is treat yourself like someone you’re responsible to help him. And Jordan Peterson talks about people who own dogs and cats. And the statistics show that people are actually better at administering prescription medications to their pets than they asked themselves. And you know, this when I read the book, it just ran a chord with me, I was like, it’s so true is, you know, our dentist, we spend all are there helping others and trying to care for others, that actually what we do, or what we seen so often in the profession, that people are running themselves into the ground. They are just not taking the time to care about their own health, to care about their own mental health, their own physical health, and as a result, we’ve got this asolutely. And you know, stressed and tired profession.

[Jaz]
Can I just interject that I mean, before I forget this point is that I went to Barry Oulton’s two-day communications course. And one interesting stat that he shared, which really was mind blowing, and I felt as though almost I knew it, but the real scale of it was, you know, surface, which is about 17% of our profession. Okay? When they did the surveys have had suicidal thoughts. I mean, we know that dentistry supposed to have the highest suicide rates, but when you actually you know, there’s five dentists a room, one of you may have had suicidal thoughts. That’s really scary. And one thing that he discussed about and also Hassan Khan discussed about in terms of his communication courses is Amy Cuddy’s TED talk about power poses, and how actually in dentistry, we’re all like this, right? And your physiology, your body, okay? It has a big effect on your sort of the neuroscience in your positivity. So take time to take a look after yourself. But also, I think one thing you’re gonna talk about now is stretching and actually lifting your body posture, because that has a profound impact on your overall mood and mental health

[David]
Oh, absolutely. I think, you know, I, one of the first things when I graduate, and I became kind of known in the middle dental communities for like the fitness side of things and the gym. And what was funny about that was I was very into kind of bodybuilding. I was and you know, I kind of hit this point where I was like, actually, you know what, I need to take better care of myself. I looked like I was physically fit, but my health wasn’t good. I went to the gym and killed some work. That’s all I did. I didn’t. I’m all being well, I didn’t do enough stretching, I didn’t do enough cardiovascular work. And I think, you know, for me, we’ve actually got to really think about the health side of things. And, hey, we know the personal, the physical and mental health are so well connected. So as you say, when you spend that entire day, in physically draining positions, be that kind of muscularly tiring positions. And, yeah, you’ve got to have the magnification, we obviously try and do a list like this without mentioning it, it was hard not to, because

[Jaz]
That’s why magnification is one benefit. But actually having a microscope and your postures up is just a great thing to consider.

[David]
And then, you know what, stand up, like I said, stand up between your patients, stand up, walk around, you know, any dentist who’s ever worked with me will know that I’m one of these dentists too, if I have everyone’s books up, and I see someone doesn’t have a patient in, and I don’t have a patient in, I always get up and leave my surgery, I got to talk to them. You know, for me, these are sort of taking care of yourself, as making sure that you’re interacting and you’re walking around, and you’re not fat in this one position. And I appreciate that there are dentists listening to this, who don’t even feel like they’ve got time to rush the toilet. To them, what I would say is, I would just say redirect yourself back to rule two, which is create a positive environment and recognize that things have to be different than that, there has to be otherwise, all you’re going to do is you’re going to run yourself down. And you know, it’s just something that, you know, early, you know, being forced to retire early with financial commitments, and I just don’t think it’s something that anyone should be having to do,

[Jaz]
or back problems. So so you know, one thing that we have, because this is 12 rules for dentistry, not just for dentists is that 94% of dentists will retire with backache. I don’t know if you knew that 94%. But do you know what percentage of nurses will retire with back problems?

[David]
At a higher percentage

[Jaz]
100%. It’s true. So one thing I’m always doing is that when I’m doing my dentistry, I’m actually looking at my nurse, and I’m actually sometimes ‘Jessica, are you comfortable? Are you okay, there? How’s your back feeling?’ And sometimes that’s a reminder for my nurse. So you know what, yeah, you’re right. Let me pick up here. So look out for one another. And one good piece of advice I was also given on the same vein was how much money do we spend on equipment? Right? As dentists and in dentistry, the most important equipment, most important machinery is yourself. So maybe go to the yoga, have a physiotherapist, get some massages, because you know, your body is an important piece of equipment, everything hinges on that. So that’s a good way to sort of reflect on it.

[David]
Yeah, absolutely. I think I couldn’t agree with you more, I think we have to, you know, the analogy, I kind of which book I read it in, we read that many kind of development books. But in the book is talking about when you’re on a plane, they always say, when there’s an emergency, put your own oxygen mask on before you help anyone else. And that’s what it comes down to it, it’s like, if you don’t help yourself, you will no longer be able to help other people. So if you retire with backache, suddenly, you’re not there for all your patients, you’re having to take time off work, you’re having to. So if you’re not looking after number one, if you’re not looking after yourself, you can’t help your family, you can’t help your patient, you can’t help the team. So actually, like we said, everything hinges on you and your health. And what’s really frustrating is I think, a lot of us notice, we still continue to drive ourselves into the ground.

[Jaz]
This is common knowledge, but we don’t surface it.

[David]
Absolutely. I work seven days a week so I can help all my patients, you think long term, are you helping your patients really? Working seven days a week, at some point that will break you, it will. It will break you because you’ve not had the time to have a good personal life and life outside of dentistry or it’ll break you from a health point of view because you spend so much time unsure the doing that, you know, in positions that are bad for your back and for your neck things like the musculoskeletal system

[Jaz]
Cool. Rule 8.

[David]
Rule 8 is Focus on your own journey. And, you know, we’ve talked about social media a few times here and it’s I think the hardest thing now is there is so much noise, there’s so much noise that, you know, do you and suddenly be bombarded with what other people are doing. And I think the biggest challenge here is what you’re actually being bombarded with is never the reality. It’s this distorted highlight reel. And you know, you’re being bombarded with positive messages about Oh, my dear, so great. Look at this, look at that. And I think sometimes we just have to block out the noise and really focus on ourselves, focus on our own journeys. And I’ve had this conversation so many times with particularly young dentists to a particular dental school, I just graduated in I say, you know what? What want to do? Well, and my friends are applying for hospital position. And that isn’t that and, and I, and I’m like, Well, what do you want to do? What do you what do you see? Where do you see yourself? What is your journey? What is? What are you destined to do? Why excites you? What interests you? Hey, you know what? It may be something that doesn’t interest me at all. I’ve talked to people who say, Oh, well, I’m really interested in dental public health. That was never for me. But if that’s somewhere else, and they should absolutely run with it, they should absolutely run with it.

[Jaz]
We need more people like that.

[David]
Absolutely, this is how the profession is all built. The profession is built on some people enjoying things and some people not enjoying them. And then everyone should just really as cheesy as it is about following your passion. You’ve got to really think big inside yourself and say, Okay, well, what is it that I like doing, and then find the path and go do that. Focus on your own journey. Focus on things that you enjoy.

[Jaz]
Sometimes the earlier years you are on a path of discovery, and that’s completely cool, just to be open yourself, like I’m discovering. I think I like this and you give it a go. Because if you don’t give it a go, then you’ll never really know. So you give it a go. But in your sort of feeding back and said okay, is this what I’m really enjoying? How can I make this even better? How can I now change my environment to design the life how I want it on you as part of your own journey? And the other thing I want to say Dave is, or never compare yourself to someone else, especially on social media, never ever compare your work on someone else? They’re in a different place. They’re on a different journey to you. But always do compare yourself to where you were a few years ago. Totally, that’s completely acceptable to do that, because that’s how you know if you’re making progress. Are you growing?

[David]
Yeah, absolutely. And, you know, I think that is one of the again, and it’s the mental health side of things. That is one of the biggest problems now. And, you know, I totally agree with you about the first few years of dentistry trying to get that exposure to as many things as possible. You know, it’s well known now that undergraduates are graduating with far too little practical experience, and that no fault of the dental schools. That is a lot of different factors involved in that. But what we’re graduating having done one molar endo, no orthodontics, and one surgical extraction, perhaps. And there’s no way that at that point, you are ready, in my opinion, to decide what you want to do for the rest of your life. And I think [Jaz] Agreed [David] it’s where we really need to bring in specialist pathway for people later on. You know, at the minute, everything is built on from day one of graduate and you have to go into this hospital position, go into this and go into this, if you want to become a specialist

[Jaz]
MFPS tick box.

[David]
Absolutely, tick, tick, tick, all you’re doing is ticking off the boxes. And before you know it, you blink and tick it. Yeah, I’m a specialist in this, and I’m a professor of you know, this, but I never actually got to go out and experience as much as possible. And, you know, I think my view is the first five years, which is what we’ve just probably come to the end of I think we’re about year six or seven. And now. Since five years for me was spent going on courses in everything. I went on an implant course, I placed implants. I didn’t enjoy it. It wasn’t for me.

[Jaz]
Same here I placed about four implants and it just wasn’t for me.

[David]
It wasn’t me. I think,

[Jaz]
But that might change, Dave, that might change me and you might look at 10 years from now look back at this episode and think, oh, we’re both placing implants now. But in terms of our progression, what we enjoyed the moment it doesn’t fit in with our what we enjoy and and that’s totally cool. It’s completely cool to say, here’s a bits that I would want to do because I enjoy them. Here’s the bits that are not for me at this moment in time. And that’s completely fine.

[David]
Yeah, absolutely. And you know, I was always like that with dentures. I’ve never enjoyed dentures. I don’t like doing dentures. I have no interest in them. And so sometimes we down to and you’ll talk about shortly, sometimes the people you meet, sometimes you meet someone, you go on you know you enjoy dentures, you go on one course with Finlay Sutton and suddenly you’re like, I love dentures. Dentures are my thing [Jaz] He totally has a effect on people. [David] And I think that is what it’s about. Sometimes I think you can only kind of go on how you feel at the minute. And I think if you don’t enjoy aspects of dentistry, and I don’t mean to criticize the National Health Service, but the NHS probably NHS dentist is you do not get that choice. You do not get a choice, you are in a contract to do everything, you can’t say and if you do say this, which some do with things like molar endo, you are breaking your contract, it is unethical and wrong to be in a contract ment and say, well, I don’t really do molar endos. So you’ll have to go private, no, it doesn’t work like that you have signed this contract. That’s what you’re saying you can do. If you don’t like aspects of dentistry, in private practice, you tell people, I am not the best man for this. I am not the person to help you with this, my colleague, and you direct people to the right people. And that’s how these private practices really thrive. That actually what ends up happening is the people who like doing certain things, do it. And the people who don’t like something, don’t have to do that anymore.

[Jaz]
Would you want your family member or even you to have brain surgery by someone who doesn’t like doing brain surgery?

[David]
No. Never.

[Jaz]
I know, we’re talking about teeth, it’s just teeth. And again, guys these are just teeth, right? But it’s important, okay? And this is what we, this is part of our values. So you need to see someone who actually enjoys what they’re doing. And you’ve got to be enjoying what you’re doing. So to make it work for everyone. So what you touched on was meeting the right people, having the right people on board. So rule number nine is amongst make quite quick one because I think you know, we have touched on this in previous reincarnation is have mentors. And one thing I want to say is that people always say, Oh, it’s so difficult to find a mentor. Well, it’s 2019, almost 2020. Okay? It has never been easier to have a mentor. Okay? If you’re a dentist in the 1950s. Okay? How do you find a mentor? Maybe local meetings, you definitely wouldn’t see new international dentists are very difficult to do. So if you want to discuss the case, you probably weren’t taking photos, to be able to show someone you sort of just describing things. Nowadays, you can take photos, you can beam across the internet within milliseconds to someone else in Costa Rica, who is a great dentist, for whatever reason, and then you’re just exchanging radiographs, information, you have video calls, it has never been easier to find a mentor. And I always say a mentor is not necessarily someone who you’ve actually met. You can have mentors who are you’ve never met before, but who are sharing excellent information and you’re learning from them. They are in some ways a mentor to you. And you are the average of the five dentists, you spend the most time with that. And that includes people who know what books are reading, who you listening to, what courses you’re going on. So find a mentor. And it’s never been easier and don’t say, It isn’t, Oh, I can’t find a mentor, just send that email, send that message. And you’ll find that some of the most successful and best Dentists out there are so generous with their time and knowledge.

[David]
So willing to help. I couldn’t agree more, I think like you say it doesn’t need elaborating on because I have just been blown away since graduating, how many phenomenal people are willing to just help out of the goodness not looking for anything in return. And, you know, and my goal has always been that, you know, eventually, I want to give back just how they are to me. And I think it’s to try and do so much with young dentists where we’ve been already because you can relate to where they’re coming from, it’s safe to give back and help with that. And But no, absolutely. There’s no better time to be a dentist, there’s no better network and opportunities to do things and than what there is now

[Jaz]
Opportunities are plentiful. So to exploit them everyone. Rule number 10 is there is no shame in saying to your patients or saying to anyone that you don’t know, it’s completely okay to say the three famous words. I don’t know. I sometimes patients ask me some is like, why is this like that? Or why was that not found? Or Why do I have this bone type appearance on this radiograph? I don’t know I’m just making up something random. And if you don’t know that, you know what? I don’t know. But I know someone who might be able to help. Or if you want sound really clever, you can say it is not known. And these nuggets have been given to me by someone called Barry Glassman, who does a fantastic lecture for S4S. And it’s completely you know, it’s a great sense of joy that you get in a way that you break the shackles from having to know everything all the time. So I don’t know if you want to elaborate on that. But I think it’s fairly it’s fairly self explanatory in the sense that, you know, if someone asked you something you don’t know just smile and say ‘You know, I don’t know or it’s not known’ if it genuinely isn’t known why something is the way it is. So it’s not known and there’s no shame in not knowing everything.

[David]
I think, I totally agree with you again, it doesn’t need much elaboration but it is for me, one of the most powerful phrases I have brought into my practice and you know, ‘I don’t know’ and I think what patients really see with that is that you’re genuine and real, you’re not trying to be bs, you’re not trying to, you know Well, it’s because I don’t know. I don’t know. And as you say, and I think that the power is when you can say, ‘I don’t know, but’ and you can say, ‘I don’t know but I can find out’ or ‘I don’t know, but I can.’ And I think this goes for, you know, when people do lecturing, and you ask someone a question and you don’t know, and they stand there and dribble out this answer to you, and you think,

[Jaz]
Just say you don’t know [David] Just say you don’t know and nothing wrong with that. And a huge one is conducted with things like choose where and more complex dentist to get, people come in and say, ‘Can you help me?’ And I think we probably saying, ‘I don’t know,’ or ‘can you help me? What do I need?’ at the minute, ‘I don’t know what you need but I can find out.’ And this is what we need to do to do that, we need to do photographs, we need to do mounted study models, if you’ve given them a journey, what you’re telling them right now, I don’t know. And we saw drilled in as dentists, you know, give patients a treatment plan, the first time you meet them. Complex dentistry can’t do that, you have to say ‘I don’t know, I need to do some certain investigations, I need to go and find out. And I think now like you said, I think there’s a lot of power in that.’

[Jaz]
Brilliant. So the last 2 rules. 11 and 12. Come on, Dave.

[David]
11 and 12 the very brief because I think we’ve covered so much. And rule 11 if you’re not enjoying things, something needs to change. And I think we don’t really talk about this too much. Because everything we’ve been talking about creating a positive environment, about trusting your gut and enjoying your journey. Everything comes down to if you don’t think this is how you’re currently operating. And this is how things currently are for you. I think the first step is recognizing something needs to change. And once you recognize that, and you come out of the denial of well, this is how it is, don’t be a victim, don’t be a victim, take off that victim t shirt and just realize that actually things need to change. And you need to identify what needs to change. And it may be to do less UDAs, it may be that you need to maybe as extreme as you need to move practice, you might need to work with different nurse, you may need to take another job elsewhere. So you can get some experience and some insight [Jaz] you might need to work in less days [David] you may need to drop a day. You know, and I think as soon as you recognize that something needs to change, that’s when you’re in control. That’s when power happens. Because at that point, then suddenly, you can make things change, and you can go on to have such a happy time in dentistry.

[Jaz]
It’s like the flower analogy again, basically, you know, it’s not the flower that needs to be changed, it’s the environment. And that, you know, it’s already been touched on. So that’s quite good in that way.

[David]
That’s it. And it’s down to you, as I say, to recognize that, hey, if you’re unhappy and you’re miserable in dentistry. Why? Why are you unhappy and miserable? Get a piece of paper write down all the reasons why you think you’re unhappy and miserable. And, you know, it may be Well, I need to treat different sorts of patients, how are you going to do that? Come with an action plan for each one. I’m working too long hours, go and have those conversations. Do I need to work these hours? Can I condense my time and do different things? Can I book longer to a new patient exam? Or an examination in general? You know, for me, five minute children exams, 10 minute adult exams was not enough. And, hey, I appreciate that some people feel false that they have to do that. What why not just work five minutes, have five minutes more, you know, 15 minute exams, these five minutes is crucial to for your own sanity I think really, nevermind anything else. And I think I picked on really nicely again to rule 12 which is Enjoy the present moment and the journey. And I think as dentists we are very, a lot of us are very type A personalities. We’re very focused and very driven. And, you know, I was reading Michelle Obama’s book recently, which is very good. And she talks about the cycle that she found herself caught in which was the effort achieved, effort achieved, effort achievex. And what we do is, when we doubt him, we do GCSEs and his effort and we achieved we get all those near stars, or whatever the new grading systems are ones and nines. We get all the top grades, what happens, we move on to AS we move on to A levels, effort achieved, we get all our is A level, what do you want to do next? All those dental schools, effort achieved. Again, constantly, you’re moving to that next level. You’re at university each year, it’s an effort achieved, and sometimes you’re too busy. You know, there’s a quote that says, you know, life is what happened. You know, it’s all about, sometimes it’s so busy making goals that actually we miss out on life. We actually forget to just enjoy the journey, and we graduate, and then we’re dentist, then we want to specialize, and you constantly on this actual activity to enjoy [Jaz] chasing the next big thing. [David] Absolutely constantly chasing something, you’re chasing the next thing, you’re chasing. And you know what? There’s always going to be a next thing if you’re not careful just to be present in the moment and think you know what, if I do, like you say, you’ve got to compare yourself to where you were two years ago, if you can look back and say, this is where I was two years ago, if I’d have said to myself two years ago, this is where I’m going to be now. Would I be happy with that? And

[Jaz]
Another question for everyone to ask for themselves, and there’s no right or wrong answer. So everyone should just reflect. And the answer is, I’m not happy than you that sort of sets a tone for your next few years.

[David]
Yeah, absolutely. You’ve got to always be a, but for me, as I said, it’s really trying to be present and really enjoy and appreciate where I am. And, and I think we should all do that I think we should all for better or for worse, stop and reflect on where we are. But enjoy the journey, not just getting some more letters, because every letter you got at CNN, you know, if you get into that cycle, you end up very lonely and miserable feeling like life passed you by but with the hundreds and hundreds of letters at CNN, for me, that’s not success for me. But successes is we can always talk about it’s so personal and so different. So anything you want to add on that?

[Jaz]
On that I almost say is I think it’s a beautiful thing that saying too, so important to enjoy the now. On the flip side, I do think that as dentists, one word, one good piece of advice I was given by an oral surgeon was that never as a dentist, stay stagnant, don’t become stagnant, always be upskilling, or trying something new or putting yourself out of your comfort zone, because that’s where growth happens. But not for the sake of present happiness, and to actually be mindful of the present moment. So you’ve got to find a balance, you shouldn’t stagnate, don’t think you’ll try to stagnate and just accept the status quo. But really, yes, develop yourself and look for the next big thing, but also appreciate the beauty and the power of now.

[David]
Yeah, absolutely. That’s it, you know, I was always told, you know, if you stay still, you’re going backwards. And it’s true, because things are changing all the time. So you have to keep evolving, you have to enjoy that journey, and appreciate and have the gratitude to just be like, wow, you know, things are really good. And I’m enjoying what I’m doing. Whilst you know, still looking at the next thing. So appreciate where you are, whilst still looking forward and trying to move forward. I think.

[Jaz]
Thank you so much for that. Thanks for joining me, it’s been really fun chatting about these 12 rules I knew it would be and I just want to say I’m so excited for you. You know, you’re hoping that you’re going to become a father soon and it’s going to be life changing. So I wish you all the best, you and Chloe all the best for that. And thanks so much for injecting our profession with positivity with more muscular hypertrophy.

[David]
It’s been an absolute pleasure, the last six, seven years knowing you and appreciate coming on.