May 13, 2026 • 44 mins
Special Offer: Get 15% OFF your first FIGS order with code FIGSUK at checkout.
Shop now at https://www.wearfigs.com/
———————————————————————
UK Dentists: Collect your verifiable CPD for this episode here >>> https://courses.dentistswhoinvest.com/smart-money-members-club
———————————————————————
If you’ve ever wondered why two clinicians can place the “same” dental implant but get wildly different long-term results, this conversation gets to the heart of it. We sit down with Dr Pav Khaira, founder of the Academy of Implant Excellence, to unpack how biomechanics, diagnostics, and patient communication combine to create predictable implant dentistry that is faster, safer, and more profitable per unit time.
We talk through the practical decisions that quietly drive success: structured diagnostics that remove uncertainty, sinus lift planning with an honest view of difficulty, and defect classification so regeneration choices are deliberate. Pav explains why biology and even the boring parts like histology matter, because healing happens at a microscopic level whether we acknowledge it or not. Stack enough small “marginal gains” and you reduce complications, post-op issues, and remakes without adding chair time.
On the biomechanics side, we get specific about implant axis, horizontal position, depth, connection type, diameter, occlusion, and why vague lab scripts like “screw retained crown please” can store up problems. We also dig into the human side: listening to anxiety, avoiding pushy sales tactics, recommending implants ethically, and building trust strong enough that patients refer friends and family. We finish by linking clinical skill to financial freedom and why IV sedation can be a game-changer for uptake and patient experience.
———————————————————————
Disclaimer: All content on this channel is for education purposes only and does not constitute an investment recommendation or individual financial advice. For that, you should speak to a regulated, independent professional. The value of investments and the income from them can go down as well as up, so you may get back less than you invest. The views expressed on this channel may no longer be current. The information provided is not a personal recommendation for any particular investment. Tax treatment depends on individual circumstances and all tax rules may change in the future. If you are unsure about the suitability of an investment, you should speak to a regulated, independent professional. Investment figures quoted refer to simulated past performance and that past performance is not a reliable indicator of future results/performance.
Listen
Watch
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr James (01:15):
We're here today to talk about implants and
specifically how we can beefficient with both our patient
outcomes and also our work time,which naturally leads to better
outcomes for all involved, bothin terms of patient
satisfaction and also in termsof profitability per unit time.
I'm joined today by Dr.
Pav Khaira, who knows thisstuff inside, but Pav is able to
(01:38):
achieve a great deal of successwhenever it comes to patient
satisfaction and all the thingswe mentioned just a second ago
more will be revealed as thispodcast progresses.
As ever, you can claim your CPDfor this episode within the
official Dentists Who InvestSmart Money Members Club.
Smart Money Members Club alsoincludes multiple mini courses
and webinar series on financefor dentists, including how to
(01:59):
become as tax efficient aspossible, as well as
understanding investing.
All of this content counts asverifiable CPD, and you can
download your certificates thereand then upon completion of
each lesson.
In addition to this, we alsoinclude a whopping 10% discount
on your dental indemnity and a5% discount on lab bills for
dental principals, amongst otherperks and discounts for
(02:21):
members.
Please use the link in thedescription to claim your
verifiable CPD for this episode.
Dr.
Pav, how we doing today, myfriend.
Both of us are riding high offthe back of the Business of
Dentistry conference over theweekend, which was fun.
Uh, I must say, there was uh400 dentists in the room in the
(02:44):
end, which is really cool, and alot of people there who were
very interested in learningabout how they can take their
careers to the next level, whichis obviously pertinent because
whenever it comes to the implantside of things, well, that's
your bag, really, isn't it?
That's my jam.
That's my jam.
He's owning it.
He's owning it.
And and fair play, because youshould mate, because what what
you've done is amazing.
(03:06):
And Pav, I gave a little bit ofan intro to you at the start of
this podcast.
Maybe it might be nice if youjust told us who you were a
little bit.
Dr Pav (03:13):
Yeah, not a problem.
So, uh, as a lot of you know,uh, my name is Dr.
Pav Caro.
I am the founder and CEO of theAcademy of Implant Excellence.
And I have uh I train andmentor other dentists, and I
have a quite a specificphilosophy, and that philosophy
(03:34):
is um patients always comefirst, and you should know your
stuff inside out.
Oh, yeah, and if you know yourstuff inside out, and you've got
good skills, and you're lookingafter the patient, the business
just rolls by itself.
I I feel a lot of people havethat backwards, and I also feel
(03:56):
that a lot of people um are nottrained to a high enough
standard.
And this this is kind of likefallout from when I did my uh
end as well.
Either got to the end of it, Iwas just like, I didn't learn a
massive amount, and that's whenit kind of like started to dawn
on me that actually, you knowwhat?
MSCs are not designed to turnyou into an expert, they're
(04:17):
designed to give you theoreticalknowledge.
And the issue that you have isuh implants, you need
theoretical knowledge, but youneed hands-on experience as
well.
You need exposure to both.
And once you start to buildexposure to both, that's when uh
that's when business changes,just transforms.
And uh the more that youunderstand about biomechanics,
(04:40):
there are two things that end uphappening.
Firstly, uh, you have fewerproblems.
Now, I'm not gonna stand, I'mnot saying I'm not gonna stand
here.
I'm actually I'm actually satdown.
I'm not gonna sit here and turnaround and say, I don't have
problems.
I do.
That's the nature of what wedo.
Okay.
But I would also sayendodontists have problems,
(05:00):
orthodontists have problems.
That's the nature of practice.
That's why we call it practice.
But the as much as we canreduce those complications, the
better.
Okay.
The other thing that we can doas well is when you can do stuff
that other people deemimpossible, and you can do it
predictably, then patients wantto come to see you because your
(05:24):
treatment plan is four monthslong, and next person's
treatment plan is 18 monthslong, and patients is just like,
why should I wait 18 months forthe outcome when I can have it
done in four people?
And that comes from genuineunderstanding of of
biomechanics, and and and I saya lot now as well.
I say, look, if if ifcolleagues understood the impact
(05:50):
of having an implant slightlyoff axis or slightly
malpositioned, quite simply theywould they would do 100% of
their cases guided.
And it's not just that, thenumber of times that I see
people when they send aprescription to the lab and they
the prescription is screwretained crown, please.
(06:13):
That is wholly inadequate, andyou are potentially without
knowing doubling or tripling theforces going through your
implant, which can lead tobiomechanical failures in the
future.
So a lot of what I teach,whilst I teach in depth, the
implementation of it is very,very simple, very
(06:35):
straightforward.
And that is my philosophy.
That's what I've that's whatI've always pushed for, that you
need to know your stuffbiomechanically in depth, in
order to achieve the bestoutcomes for patients.
That's what I love.
Dr James (06:52):
And you know what?
This is this is the good stuffright here because as someone
who's walked the walk and got towhere you have, and now I teach
dentists whenever it comes toimplants.
You believe that now you lookback when when you when you have
that, when you have that, whenyou go on that journey, you can
see things from a bird's eyeperspective, right?
And you're like, oh, okay, notonly do did you do what was
(07:13):
required to get there, but younow understand the importance
and relevance of each specificthing and how much weighting to
give it, okay.
And that's why that's sovaluable, right?
And it's the same in business,you know, someone who's got to
10 million in terms of a dentalpractice, does you know, it's
not that they work harder, it'sjust that they know what to put
their energy into a lot of thetime or what to focus on, you
(07:33):
know.
And that's the thing thatstartles me, it's just being
able to see those things.
But anyway, with relevance tothis conversation and the
implant side of things, you'reit from what you observe
throughout your career,biomechanics is the the key
differentiator between someonewho does implants and someone
who does implants superbly andefficiently and uh to the to the
(07:55):
highest possible standardleading to really great patient
outcomes.
Yeah, absolutely.
If you were to pick that, ifyou were to pick one thing, it
would be that.
Dr Pav (08:03):
Yes, yeah, that that that and the BA and the ability
to be able to communicate wellwith patients.
I think that is I think that'sgrossly, grossly underestimated.
Because it doesn't matter howgood your technical capabil
capabilities are, if you don'tknow how to listen and
communicate with patients, thatthat is then they're not going
to want to see you regardlessanyway.
(08:24):
You know, I a lot of mypatients go ahead with uh
treatment because uh not not notbecause I'm doing the
treatment, but because they feellistened to.
You know, there might theremight have been to see two or
three dentists already, and uhthe dentist uh hasn't really
addressed the fact that thepatient is extremely anxious.
You know, it's just a matterof, oh, you'll be fine.
(08:46):
And the patient's like, I'm theone that's having it done,
you're not you.
It's easy for you to say you'llbe fine.
Whereas, you know, just gentlyapproaching the patient, you
know, asking them, just say,Look, what what's making you
anxious?
What what what what's put youoff dentistry in the past?
What are you worried about?
And then, you know, just atthat point, shutting up and
(09:06):
letting them talk.
Firstly, let them get it offtheir chest, right?
And then it's not a matter ofum uh uh it's not a matter of
answer their objections.
I don't like that salestechnique because it doesn't
work well, okay.
Um there's this whole thing, itused to be, oh, find out what
their objections are, answertheir objections, and then all
(09:27):
of a sudden they'll have noobjections and they feel like
they have to go ahead withtreatment.
That's not ethical, that's notthe right way to do it.
The way to communicate withpatients is quite simply is to
give them reassurance and not bepushy.
You know, I've got somepatients where um, you know,
they don't they they don'tunderstand the power of sedation
(09:48):
and they're like, no, I'm onlyhaving this done if I can uh
have it done under generalanesthetic.
And I've got a couple ofpatients who are prepared to
who've already had treatmentdone under sedation, just as
anxious, prepared to speak tothese patients.
So I turn around and say, Howabout I get you on a phone call
with this other patient?
So you're not hearing it fromme.
I said, at that point, if youdecide that you still want to
(10:09):
have it done under generalanaesthetic, you understand I
can't do anything for youbecause I can't do it under
general anaesthetic.
So it's addressing thepatient's concerns as well.
And the reason why I say thisis because this, you know, we're
on the uh uh you know, we're onthe dentist who who invest for
them, and you know, this isabout business.
And in order to do business,you have to be able to
(10:32):
communicate with patients.
So biomechanics is one aspect,and the other aspect is is
purely communication.
Dr James (10:41):
You know, that has great value to be able to
isolate the two most importantthings for other clinicians that
are out there, andcommunication is a recurring
theme, it always comes up.
And the you know, I was on acourse once, I don't want to I
don't want to steal thelimelight here, Pav, because I
want to get into what you know,not what I know or my journey or
whatever.
But I remember I was on acourse once and it was a
communication course, and the uhpresenter, the person who's
(11:05):
running the course, he wanted tomake a point, and he was like,
Okay, cool.
What I want you to do, guys, isI want you to all write in a
piece of paper how good you are,how good you think you are at
communication out of 10, allright.
And he's like, Bear in mindfive should be the average in
this room, guys.
The average is being reset forthis room, not relative to the
rest of society, relatives ofthe dentists who are in this
room, so therefore the averageshould be five, it should be a
(11:27):
bell curve, right?
Uh, and he basically took allthe bits of paper that everybody
wrote down anonymously and hetallied them all up, and the
average was like 8.3 orsomething like that, right?
This is the thing, we all thinkwe're better than we are,
right?
But we should it should havebeen five, right?
And he was like, use that asyour yardstick.
The average tent is five, wheredo you think you are, right?
(11:48):
And um, it's almost like alittle bit of an ego blow for
some of us to be told that wecould be better at
communication, right?
And I certainly felt like that.
I was like, I know how to talkto people, uh, but you know,
back in the day in 2017 when Iqualified, all my patients took
the NHS option, right?
And that was a hundred percenthow I was framing it to them in
the rear view mirror.
(12:09):
I just didn't know it at thetime.
Uh so I guess the reason I'msharing that story, and then by
the end of the course, just torun that story off, he was like,
Okay, now I want you to go backand rate how good you were at
communication, or good, how goodyou now believe yourself to be,
or how good you uh thought youwere at the start of this day,
uh, relative to how you nowbelieve you are at the end in
(12:30):
terms of your skill out of 10.
And the average was like 5.2 orsomething like that.
You know what I mean?
People kind of saw the lightbasically.
Uh but yeah, anyway, it's aninteresting, it's kind of like
almost like a little like milddelusion that we all suffer from
that we're we think we'rereally smooth at it.
But actually, the reason I tellyou these stories is not
because to to diminish anybody,but more to say let's be
(12:51):
open-minded.
That's all I'm saying.
So you know what?
Let's focus on biomechanics.
Because I know that you've justsaid that this is the key
differentiator.
What specifically shouldimplant dentists know or do or
be aware of in order to enhancetheir treatment outcomes, their
efficiency, and then thereforetheir productivity per unit
time.
UK dentists, dentists whoinvest now has an official
(13:15):
platform where you can learnabout finance and obtain UK
compliant, verifiable CBD at thesame time.
The only platform that existson which you can do both.
The Smart Money Members Clubhas hundreds of hours of mini
courses, webinar series, andlive day recordings on all
things finance slash taxefficiency for UK dentists.
This includes complete courseson how tax works for UK
(13:37):
dentists, finance so that youcan invest and grow your own
money, business so you canimprove your profitability as an
associate or principal, and forthose out there that want it,
there's also a mini course andhow you can responsibly enter
the crypto space using measuredamounts of capital.
I've gathered this content fromthe best of the best I could
find in each respective area sothat you know that this is how
(14:00):
people at the forefront of eachfield advise their clients.
The Smart Money Members Clubalso contains discounts on
common things that UK dentistsneed to pay for on a regular
basis.
This includes a whopping 10%discount on dental indemnity,
the offer to beat your incomeprotection deal no matter what
you're paying, and for theprincipals out there, 5%
discount on lab bills and 10%discount on practice insurance.
(14:24):
These are designed to offerhundreds, if not thousands, in
annual savings.
The purpose of this membersclub is to not only boost your
monthly income but also manageyour outgoings as much as
possible and therefore createmore profit.
To celebrate the launch of theSmart Money Members Club, and
given that the CPD deadline iscoming up soon, I've decided to
offer the first month of thisplatform entirely for free.
(14:46):
This offer will end in thecoming weeks as soon as the
current CPD cycle is up.
To collect your CPD for thispodcast episode using the Smart
Money Members Club, feel free touse the link in the description
of this podcast.
Dr Pav (15:02):
So I I I I I think it falls back to a number of
factors.
And uh if I forget, remind meabout this bit a bit later on,
but um companies sponsoringcourses.
I want to come back to that bita bit later on.
Okay.
It's it's it starts withdiagnostics, okay.
If you have good diagnostics,the treatment plan almost writes
(15:26):
itself.
Okay, if you don't have gooddiagnostics, you end up with a
little bit of oh, what should Ido?
I'm not sure.
I'll give this a crack.
So actually, your um uh your uhuh your treatment plan from the
staff from the start may becompromising, you don't even
understand, you don't even knowthat.
So, for example, let's take forlet's take, for example, sinus
(15:49):
lifts.
Okay, a lot of people like, oh,I'm gonna do a crustal sinus
lift, I'm gonna do a lateralsinus lift.
Why?
What's your reasoning behindit?
Okay, what where where did youdraw that?
Where did you draw that line?
Where did you draw draw makehow did you come to that
decision?
Is this gonna be an easy caseor is this gonna be a difficult
case?
You know, what biomaterials areare you going to use?
(16:10):
Now I see people doing thesemassive, massive, massive sinus
lifts, and then uh putting verypoor quality biomaterials into
the sinus, then havingcomplications, and then
wondering why they hadcomplications.
For example, there is somethingcalled a maxillary sinus
elevation difficulty score, theMCED score.
Okay.
Now, most people who do sinuslifts have got no idea that this
(16:32):
even exists.
Okay, so they are executing asinus lift without understanding
the difficulty of it.
Okay, and there's differentdifficulty levels.
And if it's your first sinuslift and the score tells you
this is a difficult sinus lift,are you sure that's the one that
(16:53):
you should be doing first?
So this is what I'm expressingis you know, it comes down to
diagnostics, and this is and andand this is true of everything.
If you have a defect where youwant to uh where you need to
regenerate the bone, then youneed to classify that defect.
If you classify the defectsproperly, you know exactly what
(17:13):
will and what won't work.
And I'm I'm very, very umadamant on my delegates about
this.
You know, I give them proformasto help them diagnose because I
can't remember off the top ofmy head, you know, I I need
prompts to remember what Ishould be doing.
So if I need to do that, mydelegates need to do that as
well.
So first and foremost comesdiagnostics, okay, then comes uh
(17:39):
understanding biology.
And I don't mean, oh, if youcut somebody and stitch them up,
they'll kind of like healtogether.
Okay.
Or I don't mean, well, thiskind of works.
You need to knowmacroscopically what's happening
and microscopically what'shappening.
And as boring as histology is,and I know it's boring, it's
(18:00):
also the it's it's it's also thekey of what we do because
everything happens on ahistological level.
The healing cascade is on ahistological level.
So actually, if you know whatthe healing cascade is and you
know what influences at atdifferent stages, you can
manipulate that healing cascade.
And if if you can manipulate itfor the better, that also means
(18:21):
if you're not aware of it, itcan work against you if you
don't know what you're doing.
You know, it's you know, it's II have I have people turning
around saying to me, I use thesesutures.
And I turn around and say tothem, Why?
And they don't know.
Oh, it's just what I was taughtto use.
It's like, are you aware thatif you change your suture type,
your soft tissues will respondbetter?
So this is why I'm expressingthat actually, you know what,
(18:45):
understanding biomechanicsdoesn't make your treatment plan
more complicated.
Sometimes it's it's the simplethings of just switching your
your suture materials, and youswitch your suture materials and
all of a sudden your softtissues look better.
So all of this starts to add,it starts to stack on.
So we've probably all heard ofum uh uh marginal gains concept,
(19:07):
and this is the uh coach of theuh Great Britain cycling team
who uh the and the Great Britaincycling team was a uh uh you
know that they were they wereconsidered pretty much useless,
and within a very short timeframe, they ended up being world
class.
Now, apparently dopings comeinto that as well.
(19:29):
But that aside, there was therewas other things that that that
that that came into play, andit was from this coach.
And this coach was like anysingle gain that we can
potentially get, he's gonna get.
So he insisted that allcyclists shave their legs so
that there's less air drag fromhair, you know, and all of these
(19:49):
little things add up.
And I have the same mindset,and I've got other friends in in
the implant field who they havethe same mindset as well.
It's like, okay, you know what?
It may not make a massivedifference, but if it takes a
small difference and I've got 50of those things making small
differences, maybe, maybe I'm15, 20 better than if I didn't
(20:10):
do that.
And 15, 20 is all of a suddenhuge.
Now we're not talking half apercent, we're not talking one
percent.
Now we're talking about much,much bigger gains.
And we also know as well thatonce you understand um
biomechanics and biology, thisis also when you can start to do
stuff that other people deem tobe impossible.
(20:31):
So, for example, a lot ofpeople turn around and say, if
you don't have a thick buckleplate, you can't do an immediate
implant placement.
That's a load of nonsense.
You can.
There are plenty of techniquesout of out there which teach you
how to do this, and they've gotgood data behind them.
So actually, if you're sayingthat there's no buckle plate, I
(20:56):
can't do an immediate placement,all you're telling me is I
haven't read that that that thatliterature which which shows me
how to do it.
And then what ends up happeningis people are people are not
taught to think biomechanically,people are taught to think in
terms of process.
And that that really winds meup because I don't like it.
(21:16):
Because when you understandbiomechanics, the process
becomes evident by itself, andyou know when you this is when
you can start to be smart, isthink to yourself, well, you
know, normally this would takeme six appointments to get it
done.
I can do it in four andactually get a better outcome.
Patient's happy because they'renot not more trips to and from
uh uh away from work, away fromhome.
(21:38):
They get it done in a shortertime frame, less chair time for
me.
I'm happy.
And so this is why I said rightat the beginning that actually
when you understand biomechanicsand you look after patients,
the business comes by itself.
I guarantee you, if you put thebusiness first, is at some
point you will be tripped up.
(21:58):
You won't know what happened,you won't know how to fix it,
and uh things start to unravelfrom there.
So the sequence is understandbiomechanics, which starts with
uh diagnostics.
Once you have your diagnosticscorrect, uh you then need to if
you've got enough depth ofknowledge, you then start to
think, I can do this, I can dothis, I can do this.
(22:21):
And that's when it starts toget really fun.
Dr James (22:25):
I love it.
And you know, why do I get theimpression we're just scratching
the surface of what you knowwhenever it comes to this stuff,
Cab?
I'm sure there's plenty more inthat front.
And you know, just to jump intothat, actually, um okay, we've
got the diagnostics, we've gotthose in the bag, those look
really good.
Okay, and then procedurally,you you you hinted at this
earlier.
Um, procedurally, there'sthings that we can do in order
(22:47):
to enhance our outcomes that yousuggest should be common
practice, but they aren'talways.
You hinted you hinted at oneearlier, and that was using uh
guided implant placement.
Yeah.
So that's a biggie for you.
Dr Pav (23:01):
So for me, uh you don't necessarily have to go guided,
but if your implant is uh ifyour implant axis is off by even
10 15 degrees, it has a massiveimpact in the force through the
implant.
abutment interface so if you'veaccounted for that uh or even
or even if it even if it is atthe correct axis but it but it's
(23:24):
off horizontally so it's toofar like in a molar position
that actually is perpendicularbut it's too far close to to the
to the adjacent teeth andyou've got like a bit of an
overhang on on the crown thatalso uh increases force through
the uh implant abutmentinterface and through the screw
so all of this can have aproblem so when people turn
(23:46):
around and say you know I've hadscrew loosening it's like look
did you use the same screw thatcame back from the model you
know what what were yourdisinfection protocol what was
your disinfection protocolwhat's the diameter of your
implant what's the connectiontype of your implant okay
because all of this plays a rolewhat depth did you put it at
you know we we should not begetting any bone loss around the
(24:09):
margins of the implants as wellso there's two different types
of bone loss type one is calledmarginal bone loss the second
one is marginal bone remodelingthe difference between the two
is quite simple marginal boneremodeling is I put the implant
in the bone goes to the neck ofthe implant so it remodels to
the neck of the implant and itstops okay marginal bone loss is
when you put it in you cometime to restore and it's down to
(24:32):
the first thread.
So you've lost the bone you'venot remodeled it to where you
wanted it to be you've lost thebone and that comes purely down
to biology.
So if you're having bone lossaround an implant neck before
you've even restored it that'sinadequate inade inadequate
biomechanical knowledge rightthere.
So all of these things start toadd up yeah I've I've already
(24:56):
expressed before as well thatocclusion on implants is
completely different toocclusion on teeth.
So if you're giving the sameocclusal prescription on an
implant as what you do would doa natural tooth you're
potentially introducingcomplications further down the
line.
So this is why I'm saying is uhand and do you do you see what
I'm talking about here now Jamesis is that this level of depth
(25:19):
of knowledge is not increasingchair time it's doing simple
things like changing the depthof an implant at time of
placement it is choosing acertain connection type certain
diameter writing certain thingsin in the prescription so the
chair time is the same or lessbut your outcomes are vastly
(25:40):
different.
This is and this is why I'm I'mso passionate about it.
Dr James (25:45):
This is why I believe that we should be understanding
this on on on so on such a depthyeah I mean it's it's the the
reason why this is mainly soimportant is to get the b the
best outcome for the patient andeverything else flows from
there.
Yeah so here's the second thingthat happens you get all of
this right less chair time whatdo we want as you get less chair
(26:10):
time less pain uh less fewercomplications uh uh uh fewer
remakes all of that good stuffall of that good stuff greater
efficiency which is good foreveryone on every level there's
no downside to that yes nodownside you know there's not
even a sacrifice in terms ofspeed versus outcomes they're
(26:33):
actually synergistic it'sactually both these things and
it comes back to knowing thestuff that you've said and this
stuff uh do you believe thatthey go to this level of detail
in your typical masters I guessno no and how do I know that
because several of my delegateshave got master's master's
degrees and they all said thesame thing they all said look I
was taught the basics prettywell but I thought I would be an
(26:58):
expert in everything by thetime that I graduated and I
turned around say to them thatyou're not alone because I
thought the same as well.
And this isn't this isn'thaving a go at master's degrees
this is this is reframing itright that everybody's
assumption when they start amaster's degree is is is twofold
firstly you will be an expertby by by by the time you come
(27:19):
out and secondly patientsactually care about these
letters after your name and theanswer to both of those is no
not really you know you saidsomething really interesting
once and I always meant to askyou about this and I feel like
it's relevant to thisconversation so let me ask you
now I remember we were talkingonce or perhaps you were
(27:39):
possibly speaking in front of aroom as well and I remember you
saying this and we were talkingabout the the uh career path of
an implant dentist right like ifyou want to uh propel yourself
or you want to progress furtherdown that path right so it
starts out single tooth multipletooth then maybe all on four or
something like that you knowwhat I mean and again it doesn't
(28:02):
look like that for everybodybut okay that's your typical
progression and I remember yousaid something really
interesting and you said youknow what I used to think all on
four was a pinnacle but now Iknow it's not even close.
Dr Pav (28:12):
Yeah what did you mean by that I mean it it is such a
varied and diverse field is it'skind of where it's it's it's
like where do you stop right soyou go from uh you go from all
on four to uh and and then yousplit it down are are you
talking uh uh fp3 type uhprosthesis which is your typical
(28:36):
what you see all on four or areyou talking like uh FP1 uh
prosthesis which is basicallyjust replacing the teeth okay
then there's like okay well um Ican't get the implants in the
right position uh we need tostart doing pterygoids then you
get good at pterygoids then youneed to look at transnasal
implants then you start lookingat zygomatic implants then you
(28:56):
start looking at subperiostealframes and once you can do all
of that you know what yourfavorite case becomes that
single implant out of the smilewhere there's plenty of bone and
you know it's going to take youfive minutes to do.
So that is the full circle thatis the full circle you
constantly want to be I want tobe able to do this complex work.
I want to be able to do thiscomplex work.
(29:18):
In order to do the complex workyou have to be able to deal
with the fallout part from it aswell.
And again on that full archthing and this again goes back
to diagnostics treatmentplanning and understanding
everything is there is adisgusting overuse of FP3 where
people are just hammering thehell out of the boat.
Dr James (29:40):
And uh it's it it it is it's easy it's easy right the
other way to do it yes thereare fewer cases where it can be
done but even in these caseswhere it can be done the uh the
the the technical need from thesurgeon and the technician jumps
(30:01):
significantly so it's almost acase of damned if you do and a
damned if you don't because onone hand you have an easier
treatment plan but it'sextremely destructive but on the
on the on the flip side of thatcoin is you have a much better
outcome and treatment plan whichis technically more demanding
(30:21):
for you and your technician andthe truth probably lies
somewhere between in between youknow we're not Sith we don't
deal in absolutes the the thetruth probably lies uh probably
probably lies somewhere inbetween but then this goes back
to if you know uhbiomechanically what you should
(30:41):
be doing you can make theappropriate decisions you can
make the appropriate outcomesthat's what it comes down to let
me see okay interesting justprocessing that yeah fair enough
fair enough and um I don't knowI'm I'm actually I'm actually a
bit disappointed in myself thatI didn't get that star for Star
(31:03):
Wars reference right there thethe Sith dealing in absolutes I
must have I must have missedthat part of uh of Star Wars uh
but uh yeah anyway maybe maybethat's a feature kind of a
recurring theme of the the Sithversus the Jedi I don't know I
didn't know that one but thereyou there you go uh but yes
anyway no um thank you for thatpal thank you for shedding light
(31:24):
on that and you know I alsowanted to touch upon
communication given that that'sso important as well to all the
things that we mentioned earlierin this podcast I know that you
mentioned that a lot of thetime dentists aren't doing the
basics like addressing theelephant in the room like why
the patient is in a certainemotional state whenever they
(31:44):
come to see you and often thepatient can't really they almost
are not even aware necessarilyof why and you you can't just
say why are you anxious rightyou just have to say you can say
something like what's goingthrough your head or was there a
particular occasion in the pastthat made you feel a certain
way or kind of put you off beinga dentist or I don't know.
(32:07):
You know something like that.
The key thing I understand isthe patients they don't always
know why they feel a certain wayright so that's an example.
And then can you think of anyother methodologies or practices
that you have whenever it comesto communication that seem to
facilitate you doing reallygreat implant work.
Specifically with regards to uhanxiety or or relating to abuse
(32:30):
I think you know what I thinkgenerally and I think things
that how can they say thisalmost like if you observe other
dentists which I'm sure you dothrough your mentoring okay and
their communication styles likemaybe frequent clangers that
they drop that you that youdon't do or things that you feel
that if they address thesethings they'll all of a sudden
(32:52):
just become so much moresmoother whenever it comes to
their patient interactions.
Dr Pav (32:57):
So I've so I've I've I've got a couple of good ones
so first having confidence inyourself nice which goes back to
understanding biomechanicsproperly okay um but quite often
what happens is when dentistsstart talking to a patient who
needs to have a tooth removedthe way that they approach it is
oh once you have a toothremoved you can leave it as a
(33:18):
space you can uh have a denturea denture comes in one of two
forms you can have somethingacrylic which comes in and out
you can have something with ametal substructure you can have
a bridge a bridge is fixed inyour mouth it uh uh but you need
to it requires preparation ofthe adjacent teeth and then
almost flippantly at the end ohyou can also have an implant
(33:38):
okay firstly that hierarchiesbackwards okay from forgetting
patient anxiety forgetting forforgetting patient desires
forgetting fun and money all ofthat okay purely from a
biomechanical point of view oncea tooth is removed the next
best thing is is an implant endof discussion everything else is
(34:01):
one step back from that okay orseveral step backs from that
and the patients need tounderstand this if they don't
want to have an implant donethat's absolutely fine the other
thing that dentists mistakenlythink as well they mistakenly
think that we cannot offertreatment recommendations to
patients which is a load ofnonsense you are medico legally
(34:21):
uh permitted to say you know youneed to have this tooth out
there's nothing better thanhaving an implant put back into
its place.
The pros and cons of implantsare this here are your
alternatives that's it that'swhat it comes down to.
So I actually turn around andsay to my patients that you know
um uh purely from abiomechanical point of view I
(34:45):
know that this isn't in thecorner of your smile but it's an
important chewing tooth youdon't have to have it replaced
but my recommendation would bethat you have it placed there's
the you know can you see there'sa difference in that discussion
and then the other thing that Isee as well is is people turn
around say um oh I want to getstarted in implants but there's
not that many implants in in inmy practice is we just we just
(35:07):
don't do them.
I turn around say to them howmany teeth do you take out per
month oh between 15 and 20 likeright how many of these patients
are you telling they wouldbenefit from them from an
implant oh I'm not telling themthere's your problem there's
your problem you know if you ifyou if you've got good
communication skills and youtell 20 people uh uh in uh who
(35:30):
are having the tooth removed yesI know some people can't afford
it and there are certainpractices uh where the
demographic don't fit but inyour average practice either a
private practice or a mixedpractice a lot of people will go
ahead but I'm not recommendingpatients um uh to have treatment
done um purely for my for myown wallet I'm doing it because
(35:53):
I genuinely believe it's intheir best interest I had one
gentleman about six months agouh elderly um his teeth are
falling out from period uh he'shad simple dentures before in
the past absolutely hates themuh he told me he has the funds
for it he has the desire to doit um he was a little bit
(36:13):
anxious but I thought we cansedate him that'll be fine but
then he said something to me andI refused to do the treatment
for him and he expressed concernthat his wife's health is not
as well as what it should be andshe may need that money in the
future to be looked after.
(36:35):
And I quite simply turnedaround and said to him you know
what I don't think this is theright thing for you to do
because if it was me in thatsituation I wouldn't want to do
it.
So my recommendation to himbecame look there's a handful
that there's a handful of moreteeth that need to be removed.
Have a really nice set ofdentures made if you don't get
(36:58):
on with them come back to mebecause then we have more
options.
I said but if you do get onwith them fine that we you don't
need to have anything furtherdone so whatever we recommend to
patients have has to be intheir best interests.
Now a lot of people will turnaround and say well you're
shooting yourself in the footpav because you know you could
have done a really big goularchcase and that would have been
good income.
Yes it would have been okay butwhat I would rather happen is I
(37:22):
would rather be him be outturning around saying to his
friends and family oh you needto have a two three go see Pav
because he'll give you an honestanswer.
And honesty is it's it's itneeds to be uh further for uh on
the forefront of what we do aswell because without that
(37:46):
honesty aspect you know it'swith with my communication
skills would have been easy toget convince him to have the
treatment done would it havebeen the right thing for him
purely from a dental point ofview yes but fitting it into his
life and the other stuff thathad that he had going on
wouldn't have been the rightthing to do.
(38:06):
It would have been unethical ofme and I I didn't want to do it
so I actually refuse to do histreatment so this is where
communication comes in uh thatwe need to be able to have these
commun that these discussionswith patients and if you if you
have these discussions withpatients and if you're good at
(38:26):
communicating your biggestproblem is going to be I don't
place implants or I can onlyplace the basics I need to have
more training to do the morecomplex stuff you know you don't
have to become um purely uh animplantologist okay um that that
that's what I do okay I've gota handful of dentists where uh
(38:49):
sorry I've got a handful ofdelegates where that's all they
do they do implants they do theythey do nothing else but 95% of
my delegates they're actuallygeneral dentists and they
wouldn't want to step away fromthe general dentistry side
because they enjoy it too muchme I don't like it I'm not
interested in that the so Istick to just the just the just
just the implant side soeverybody's career and pathway
(39:14):
and progression is different andwe need to respect that but
whether you're learning implantswhether you're learning endo
whether you're learning orthoyou should be passionate about
it enough that you will neverstop learning I still learn I'm
going on courses this year Ihave my mentors that will never
stop uh uh uh never thatlearning will never stop for me
(39:38):
and I believe that we should allkind of like be the same in in
what in whatever field we wantto do even outside of dentistry
if you're in another professionyou should be passionate about
it because the the moreknowledge you have the more
skills you gain the more you cando things that other people
cannot do and you end up beingin a position where you have
less and less competition that'sthe way that I look at it.
Dr James (40:00):
Yeah 100% and you know you know on that actually
obviously this is the DennisonInvest podcast and people come
to me all the time and they'relike okay cool how can I be
financially free and definitelyinvesting is part of that.
Like obviously you want to haveyour pension and your ICIN and
everything along those lines butwhat actually generates funds
(40:21):
for the pension and the ICIN inthe first place yeah what's your
great you have two levers youliterally have two levers when
it comes to your investmentportfolio you can either boost
returns or you can boostcontributions.
Those are your only two levers.
There's literally one of thosetwo things and returns is a
function of the return of theinvestment the appreciation of
the investment manage the feesright so obviously you reduce
(40:44):
the fees and you boost theappreciation of the investment.
But when you know a little bitabout the stock market and when
you know a little bit aboutinvesting I mean it's very hard
to beat the market it's veryhard to beat the S P 500 okay
it's like is you know most fundsmanaged by professional
managers fail to do that.
So the odds of you doing thatare really slim like 3%.
I think it's like 3% of activefunds beat passive funds okay
(41:07):
and those are professionals yeahso what I'm saying is that when
you realistically you're onlygoing to really max out around
the level of returns of the SPsthe S P right so that's the most
that you can ever boost yourreturns.
Therefore you have to look atthe other lever which is how can
you boost your contributionsand what literally puts money in
the investment portfolio isyour skills.
(41:28):
And people don't get thatenough if you ask me I
personally believe that if youreally want to accelerate your
wealth journey you should lookat your cash flow and where that
comes from and part of that isbeing able to do really high
qual really specialist workbecause obviously it carries
more of a premium but alsoreally high quality and really
efficient which is actuallyexactly what this podcast is
about.
(41:48):
And honestly I feel that ifpeople got that and embraced it
that a lot more rather thancontinuously looking for an
investment edge they'd probablyget to where they want to go a
lot faster.
Dr Pav (41:59):
It's a mindset thing as much as an absolutely yeah
absolutely agree and uh anotheraspect on top of what we've been
discussing as well is um youknow uh Ivy sedation you know
quite simply is it it if ifpatients want to have implants
done they will be anxious aboutit um even if to me I know it's
(42:20):
going to take me five minutes toplace this implant for the
patient they're like well I'vehad a filling done before I've
had a crown done before but he'stalking about drilling into my
skull and psychologically theycan't handle that.
Well actually I can do it underIV sedation you'll be away with
the fairies you won't have theyou won't have a clue what's
going on.
Okay great now I'll have itdone.
So actually if you do asignificant amount of of surgery
(42:44):
and uh and implants I dobelieve IV sedation goes hand in
hand.
And then what happens is onceyou have that skill you don't
have to limit it to just surgeryyou can roll it out to general
dentistry.
You know IV sedation is afantastic and extremely powerful
tool.
Dr James (43:03):
Knowledge has been dropped on this podcast today.
Thank you Dr.
Pav Pav if anybody is listeningto this podcast and they want
to find you and talk to youabout anything that you've
mentioned today where are theybest off where are they best
able to do that?
Dr Pav (43:14):
Yeah so uh if you're uh somebody's interested in the
academy it's very simplyacademyofimplantecellence dot
com.
Uh you can find me on Instagramdr dot pav uh dotkera uh
there's academy of implantexcellence uh instagram uh
handle as well so uh lots ofways to to to to to to get hold
(43:36):
of me and and get in touch withme uh what I wouldn't say is uh
those who join the academy theytend to be and I've I've
mentioned before that I've gotpeople who've done master's
degrees but I've also gotcomplete novice novices
completely new to implants uhwhat they all have uh in in in
(43:59):
what they all have in common isa very similar mindset to myself
that actually you know what ifyou learn biomechanics you do a
better job the rest becomes easyand the business comes by
itself so these are people whowant to learn real biomechanics
so
We're here today to talk about implants and
specifically how we can beefficient with both our patient
outcomes and also our work time,which naturally leads to better
outcomes for all involved, bothin terms of patient
satisfaction and also in termsof profitability per unit time.
I'm joined today by Dr.
Pav Khaira, who knows thisstuff inside, but Pav is able to
(01:38):
achieve a great deal of successwhenever it comes to patient
satisfaction and all the thingswe mentioned just a second ago
more will be revealed as thispodcast progresses.
As ever, you can claim your CPDfor this episode within the
official Dentists Who InvestSmart Money Members Club.
Smart Money Members Club alsoincludes multiple mini courses
and webinar series on financefor dentists, including how to
(01:59):
become as tax efficient aspossible, as well as
understanding investing.
All of this content counts asverifiable CPD, and you can
download your certificates thereand then upon completion of
each lesson.
In addition to this, we alsoinclude a whopping 10% discount
on your dental indemnity and a5% discount on lab bills for
dental principals, amongst otherperks and discounts for
(02:21):
members.
Please use the link in thedescription to claim your
verifiable CPD for this episode.
Dr.
Pav, how we doing today, myfriend.
Both of us are riding high offthe back of the Business of
Dentistry conference over theweekend, which was fun.
Uh, I must say, there was uh400 dentists in the room in the
(02:44):
end, which is really cool, and alot of people there who were
very interested in learningabout how they can take their
careers to the next level, whichis obviously pertinent because
whenever it comes to the implantside of things, well, that's
your bag, really, isn't it?
That's my jam.
That's my jam.
He's owning it.
He's owning it.
And and fair play, because youshould mate, because what what
you've done is amazing.
(03:06):
And Pav, I gave a little bit ofan intro to you at the start of
this podcast.
Maybe it might be nice if youjust told us who you were a
little bit.
Dr Pav (03:13):
Yeah, not a problem.
So, uh, as a lot of you know,uh, my name is Dr.
Pav Caro.
I am the founder and CEO of theAcademy of Implant Excellence.
And I have uh I train andmentor other dentists, and I
have a quite a specificphilosophy, and that philosophy
(03:34):
is um patients always comefirst, and you should know your
stuff inside out.
Oh, yeah, and if you know yourstuff inside out, and you've got
good skills, and you're lookingafter the patient, the business
just rolls by itself.
I I feel a lot of people havethat backwards, and I also feel
(03:56):
that a lot of people um are nottrained to a high enough
standard.
And this this is kind of likefallout from when I did my uh
end as well.
Either got to the end of it, Iwas just like, I didn't learn a
massive amount, and that's whenit kind of like started to dawn
on me that actually, you knowwhat?
MSCs are not designed to turnyou into an expert, they're
(04:17):
designed to give you theoreticalknowledge.
And the issue that you have isuh implants, you need
theoretical knowledge, but youneed hands-on experience as
well.
You need exposure to both.
And once you start to buildexposure to both, that's when uh
that's when business changes,just transforms.
And uh the more that youunderstand about biomechanics,
(04:40):
there are two things that end uphappening.
Firstly, uh, you have fewerproblems.
Now, I'm not gonna stand, I'mnot saying I'm not gonna stand
here.
I'm actually I'm actually satdown.
I'm not gonna sit here and turnaround and say, I don't have
problems.
I do.
That's the nature of what wedo.
Okay.
But I would also sayendodontists have problems,
(05:00):
orthodontists have problems.
That's the nature of practice.
That's why we call it practice.
But the as much as we canreduce those complications, the
better.
Okay.
The other thing that we can doas well is when you can do stuff
that other people deemimpossible, and you can do it
predictably, then patients wantto come to see you because your
(05:24):
treatment plan is four monthslong, and next person's
treatment plan is 18 monthslong, and patients is just like,
why should I wait 18 months forthe outcome when I can have it
done in four people?
And that comes from genuineunderstanding of of
biomechanics, and and and I saya lot now as well.
I say, look, if if ifcolleagues understood the impact
(05:50):
of having an implant slightlyoff axis or slightly
malpositioned, quite simply theywould they would do 100% of
their cases guided.
And it's not just that, thenumber of times that I see
people when they send aprescription to the lab and they
the prescription is screwretained crown, please.
(06:13):
That is wholly inadequate, andyou are potentially without
knowing doubling or tripling theforces going through your
implant, which can lead tobiomechanical failures in the
future.
So a lot of what I teach,whilst I teach in depth, the
implementation of it is very,very simple, very
(06:35):
straightforward.
And that is my philosophy.
That's what I've that's whatI've always pushed for, that you
need to know your stuffbiomechanically in depth, in
order to achieve the bestoutcomes for patients.
That's what I love.
Dr James (06:52):
And you know what?
This is this is the good stuffright here because as someone
who's walked the walk and got towhere you have, and now I teach
dentists whenever it comes toimplants.
You believe that now you lookback when when you when you have
that, when you have that, whenyou go on that journey, you can
see things from a bird's eyeperspective, right?
And you're like, oh, okay, notonly do did you do what was
(07:13):
required to get there, but younow understand the importance
and relevance of each specificthing and how much weighting to
give it, okay.
And that's why that's sovaluable, right?
And it's the same in business,you know, someone who's got to
10 million in terms of a dentalpractice, does you know, it's
not that they work harder, it'sjust that they know what to put
their energy into a lot of thetime or what to focus on, you
(07:33):
know.
And that's the thing thatstartles me, it's just being
able to see those things.
But anyway, with relevance tothis conversation and the
implant side of things, you'reit from what you observe
throughout your career,biomechanics is the the key
differentiator between someonewho does implants and someone
who does implants superbly andefficiently and uh to the to the
(07:55):
highest possible standardleading to really great patient
outcomes.
Yeah, absolutely.
If you were to pick that, ifyou were to pick one thing, it
would be that.
Dr Pav (08:03):
Yes, yeah, that that that and the BA and the ability
to be able to communicate wellwith patients.
I think that is I think that'sgrossly, grossly underestimated.
Because it doesn't matter howgood your technical capabil
capabilities are, if you don'tknow how to listen and
communicate with patients, thatthat is then they're not going
to want to see you regardlessanyway.
(08:24):
You know, I a lot of mypatients go ahead with uh
treatment because uh not not notbecause I'm doing the
treatment, but because they feellistened to.
You know, there might theremight have been to see two or
three dentists already, and uhthe dentist uh hasn't really
addressed the fact that thepatient is extremely anxious.
You know, it's just a matterof, oh, you'll be fine.
(08:46):
And the patient's like, I'm theone that's having it done,
you're not you.
It's easy for you to say you'llbe fine.
Whereas, you know, just gentlyapproaching the patient, you
know, asking them, just say,Look, what what's making you
anxious?
What what what what's put youoff dentistry in the past?
What are you worried about?
And then, you know, just atthat point, shutting up and
(09:06):
letting them talk.
Firstly, let them get it offtheir chest, right?
And then it's not a matter ofum uh uh it's not a matter of
answer their objections.
I don't like that salestechnique because it doesn't
work well, okay.
Um there's this whole thing, itused to be, oh, find out what
their objections are, answertheir objections, and then all
(09:27):
of a sudden they'll have noobjections and they feel like
they have to go ahead withtreatment.
That's not ethical, that's notthe right way to do it.
The way to communicate withpatients is quite simply is to
give them reassurance and not bepushy.
You know, I've got somepatients where um, you know,
they don't they they don'tunderstand the power of sedation
(09:48):
and they're like, no, I'm onlyhaving this done if I can uh
have it done under generalanesthetic.
And I've got a couple ofpatients who are prepared to
who've already had treatmentdone under sedation, just as
anxious, prepared to speak tothese patients.
So I turn around and say, Howabout I get you on a phone call
with this other patient?
So you're not hearing it fromme.
I said, at that point, if youdecide that you still want to
(10:09):
have it done under generalanaesthetic, you understand I
can't do anything for youbecause I can't do it under
general anaesthetic.
So it's addressing thepatient's concerns as well.
And the reason why I say thisis because this, you know, we're
on the uh uh you know, we're onthe dentist who who invest for
them, and you know, this isabout business.
And in order to do business,you have to be able to
(10:32):
communicate with patients.
So biomechanics is one aspect,and the other aspect is is
purely communication.
Dr James (10:41):
You know, that has great value to be able to
isolate the two most importantthings for other clinicians that
are out there, andcommunication is a recurring
theme, it always comes up.
And the you know, I was on acourse once, I don't want to I
don't want to steal thelimelight here, Pav, because I
want to get into what you know,not what I know or my journey or
whatever.
But I remember I was on acourse once and it was a
communication course, and the uhpresenter, the person who's
(11:05):
running the course, he wanted tomake a point, and he was like,
Okay, cool.
What I want you to do, guys, isI want you to all write in a
piece of paper how good you are,how good you think you are at
communication out of 10, allright.
And he's like, Bear in mindfive should be the average in
this room, guys.
The average is being reset forthis room, not relative to the
rest of society, relatives ofthe dentists who are in this
room, so therefore the averageshould be five, it should be a
(11:27):
bell curve, right?
Uh, and he basically took allthe bits of paper that everybody
wrote down anonymously and hetallied them all up, and the
average was like 8.3 orsomething like that, right?
This is the thing, we all thinkwe're better than we are,
right?
But we should it should havebeen five, right?
And he was like, use that asyour yardstick.
The average tent is five, wheredo you think you are, right?
(11:48):
And um, it's almost like alittle bit of an ego blow for
some of us to be told that wecould be better at
communication, right?
And I certainly felt like that.
I was like, I know how to talkto people, uh, but you know,
back in the day in 2017 when Iqualified, all my patients took
the NHS option, right?
And that was a hundred percenthow I was framing it to them in
the rear view mirror.
(12:09):
I just didn't know it at thetime.
Uh so I guess the reason I'msharing that story, and then by
the end of the course, just torun that story off, he was like,
Okay, now I want you to go backand rate how good you were at
communication, or good, how goodyou now believe yourself to be,
or how good you uh thought youwere at the start of this day,
uh, relative to how you nowbelieve you are at the end in
(12:30):
terms of your skill out of 10.
And the average was like 5.2 orsomething like that.
You know what I mean?
People kind of saw the lightbasically.
Uh but yeah, anyway, it's aninteresting, it's kind of like
almost like a little like milddelusion that we all suffer from
that we're we think we'rereally smooth at it.
But actually, the reason I tellyou these stories is not
because to to diminish anybody,but more to say let's be
(12:51):
open-minded.
That's all I'm saying.
So you know what?
Let's focus on biomechanics.
Because I know that you've justsaid that this is the key
differentiator.
What specifically shouldimplant dentists know or do or
be aware of in order to enhancetheir treatment outcomes, their
efficiency, and then thereforetheir productivity per unit
time.
UK dentists, dentists whoinvest now has an official
(13:15):
platform where you can learnabout finance and obtain UK
compliant, verifiable CBD at thesame time.
The only platform that existson which you can do both.
The Smart Money Members Clubhas hundreds of hours of mini
courses, webinar series, andlive day recordings on all
things finance slash taxefficiency for UK dentists.
This includes complete courseson how tax works for UK
(13:37):
dentists, finance so that youcan invest and grow your own
money, business so you canimprove your profitability as an
associate or principal, and forthose out there that want it,
there's also a mini course andhow you can responsibly enter
the crypto space using measuredamounts of capital.
I've gathered this content fromthe best of the best I could
find in each respective area sothat you know that this is how
(14:00):
people at the forefront of eachfield advise their clients.
The Smart Money Members Clubalso contains discounts on
common things that UK dentistsneed to pay for on a regular
basis.
This includes a whopping 10%discount on dental indemnity,
the offer to beat your incomeprotection deal no matter what
you're paying, and for theprincipals out there, 5%
discount on lab bills and 10%discount on practice insurance.
(14:24):
These are designed to offerhundreds, if not thousands, in
annual savings.
The purpose of this membersclub is to not only boost your
monthly income but also manageyour outgoings as much as
possible and therefore createmore profit.
To celebrate the launch of theSmart Money Members Club, and
given that the CPD deadline iscoming up soon, I've decided to
offer the first month of thisplatform entirely for free.
(14:46):
This offer will end in thecoming weeks as soon as the
current CPD cycle is up.
To collect your CPD for thispodcast episode using the Smart
Money Members Club, feel free touse the link in the description
of this podcast.
Dr Pav (15:02):
So I I I I I think it falls back to a number of
factors.
And uh if I forget, remind meabout this bit a bit later on,
but um companies sponsoringcourses.
I want to come back to that bita bit later on.
Okay.
It's it's it starts withdiagnostics, okay.
If you have good diagnostics,the treatment plan almost writes
(15:26):
itself.
Okay, if you don't have gooddiagnostics, you end up with a
little bit of oh, what should Ido?
I'm not sure.
I'll give this a crack.
So actually, your um uh your uhuh your treatment plan from the
staff from the start may becompromising, you don't even
understand, you don't even knowthat.
So, for example, let's take forlet's take, for example, sinus
(15:49):
lifts.
Okay, a lot of people like, oh,I'm gonna do a crustal sinus
lift, I'm gonna do a lateralsinus lift.
Why?
What's your reasoning behindit?
Okay, what where where did youdraw that?
Where did you draw that line?
Where did you draw draw makehow did you come to that
decision?
Is this gonna be an easy caseor is this gonna be a difficult
case?
You know, what biomaterials areare you going to use?
(16:10):
Now I see people doing thesemassive, massive, massive sinus
lifts, and then uh putting verypoor quality biomaterials into
the sinus, then havingcomplications, and then
wondering why they hadcomplications.
For example, there is somethingcalled a maxillary sinus
elevation difficulty score, theMCED score.
Okay.
Now, most people who do sinuslifts have got no idea that this
(16:32):
even exists.
Okay, so they are executing asinus lift without understanding
the difficulty of it.
Okay, and there's differentdifficulty levels.
And if it's your first sinuslift and the score tells you
this is a difficult sinus lift,are you sure that's the one that
(16:53):
you should be doing first?
So this is what I'm expressingis you know, it comes down to
diagnostics, and this is and andand this is true of everything.
If you have a defect where youwant to uh where you need to
regenerate the bone, then youneed to classify that defect.
If you classify the defectsproperly, you know exactly what
(17:13):
will and what won't work.
And I'm I'm very, very umadamant on my delegates about
this.
You know, I give them proformasto help them diagnose because I
can't remember off the top ofmy head, you know, I I need
prompts to remember what Ishould be doing.
So if I need to do that, mydelegates need to do that as
well.
So first and foremost comesdiagnostics, okay, then comes uh
(17:39):
understanding biology.
And I don't mean, oh, if youcut somebody and stitch them up,
they'll kind of like healtogether.
Okay.
Or I don't mean, well, thiskind of works.
You need to knowmacroscopically what's happening
and microscopically what'shappening.
And as boring as histology is,and I know it's boring, it's
(18:00):
also the it's it's it's also thekey of what we do because
everything happens on ahistological level.
The healing cascade is on ahistological level.
So actually, if you know whatthe healing cascade is and you
know what influences at atdifferent stages, you can
manipulate that healing cascade.
And if if you can manipulate itfor the better, that also means
(18:21):
if you're not aware of it, itcan work against you if you
don't know what you're doing.
You know, it's you know, it's II have I have people turning
around saying to me, I use thesesutures.
And I turn around and say tothem, Why?
And they don't know.
Oh, it's just what I was taughtto use.
It's like, are you aware thatif you change your suture type,
your soft tissues will respondbetter?
So this is why I'm expressingthat actually, you know what,
(18:45):
understanding biomechanicsdoesn't make your treatment plan
more complicated.
Sometimes it's it's the simplethings of just switching your
your suture materials, and youswitch your suture materials and
all of a sudden your softtissues look better.
So all of this starts to add,it starts to stack on.
So we've probably all heard ofum uh uh marginal gains concept,
(19:07):
and this is the uh coach of theuh Great Britain cycling team
who uh the and the Great Britaincycling team was a uh uh you
know that they were they wereconsidered pretty much useless,
and within a very short timeframe, they ended up being world
class.
Now, apparently dopings comeinto that as well.
(19:29):
But that aside, there was therewas other things that that that
that that came into play, andit was from this coach.
And this coach was like anysingle gain that we can
potentially get, he's gonna get.
So he insisted that allcyclists shave their legs so
that there's less air drag fromhair, you know, and all of these
(19:49):
little things add up.
And I have the same mindset,and I've got other friends in in
the implant field who they havethe same mindset as well.
It's like, okay, you know what?
It may not make a massivedifference, but if it takes a
small difference and I've got 50of those things making small
differences, maybe, maybe I'm15, 20 better than if I didn't
(20:10):
do that.
And 15, 20 is all of a suddenhuge.
Now we're not talking half apercent, we're not talking one
percent.
Now we're talking about much,much bigger gains.
And we also know as well thatonce you understand um
biomechanics and biology, thisis also when you can start to do
stuff that other people deem tobe impossible.
(20:31):
So, for example, a lot ofpeople turn around and say, if
you don't have a thick buckleplate, you can't do an immediate
implant placement.
That's a load of nonsense.
You can.
There are plenty of techniquesout of out there which teach you
how to do this, and they've gotgood data behind them.
So actually, if you're sayingthat there's no buckle plate, I
(20:56):
can't do an immediate placement,all you're telling me is I
haven't read that that that thatliterature which which shows me
how to do it.
And then what ends up happeningis people are people are not
taught to think biomechanically,people are taught to think in
terms of process.
And that that really winds meup because I don't like it.
(21:16):
Because when you understandbiomechanics, the process
becomes evident by itself, andyou know when you this is when
you can start to be smart, isthink to yourself, well, you
know, normally this would takeme six appointments to get it
done.
I can do it in four andactually get a better outcome.
Patient's happy because they'renot not more trips to and from
uh uh away from work, away fromhome.
(21:38):
They get it done in a shortertime frame, less chair time for
me.
I'm happy.
And so this is why I said rightat the beginning that actually
when you understand biomechanicsand you look after patients,
the business comes by itself.
I guarantee you, if you put thebusiness first, is at some
point you will be tripped up.
(21:58):
You won't know what happened,you won't know how to fix it,
and uh things start to unravelfrom there.
So the sequence is understandbiomechanics, which starts with
uh diagnostics.
Once you have your diagnosticscorrect, uh you then need to if
you've got enough depth ofknowledge, you then start to
think, I can do this, I can dothis, I can do this.
(22:21):
And that's when it starts toget really fun.
Dr James (22:25):
I love it.
And you know, why do I get theimpression we're just scratching
the surface of what you knowwhenever it comes to this stuff,
Cab?
I'm sure there's plenty more inthat front.
And you know, just to jump intothat, actually, um okay, we've
got the diagnostics, we've gotthose in the bag, those look
really good.
Okay, and then procedurally,you you you hinted at this
earlier.
Um, procedurally, there'sthings that we can do in order
(22:47):
to enhance our outcomes that yousuggest should be common
practice, but they aren'talways.
You hinted you hinted at oneearlier, and that was using uh
guided implant placement.
Yeah.
So that's a biggie for you.
Dr Pav (23:01):
So for me, uh you don't necessarily have to go guided,
but if your implant is uh ifyour implant axis is off by even
10 15 degrees, it has a massiveimpact in the force through the
implant.
abutment interface so if you'veaccounted for that uh or even
or even if it even if it is atthe correct axis but it but it's
(23:24):
off horizontally so it's toofar like in a molar position
that actually is perpendicularbut it's too far close to to the
to the adjacent teeth andyou've got like a bit of an
overhang on on the crown thatalso uh increases force through
the uh implant abutmentinterface and through the screw
so all of this can have aproblem so when people turn
(23:46):
around and say you know I've hadscrew loosening it's like look
did you use the same screw thatcame back from the model you
know what what were yourdisinfection protocol what was
your disinfection protocolwhat's the diameter of your
implant what's the connectiontype of your implant okay
because all of this plays a rolewhat depth did you put it at
you know we we should not begetting any bone loss around the
(24:09):
margins of the implants as wellso there's two different types
of bone loss type one is calledmarginal bone loss the second
one is marginal bone remodelingthe difference between the two
is quite simple marginal boneremodeling is I put the implant
in the bone goes to the neck ofthe implant so it remodels to
the neck of the implant and itstops okay marginal bone loss is
when you put it in you cometime to restore and it's down to
(24:32):
the first thread.
So you've lost the bone you'venot remodeled it to where you
wanted it to be you've lost thebone and that comes purely down
to biology.
So if you're having bone lossaround an implant neck before
you've even restored it that'sinadequate inade inadequate
biomechanical knowledge rightthere.
So all of these things start toadd up yeah I've I've already
(24:56):
expressed before as well thatocclusion on implants is
completely different toocclusion on teeth.
So if you're giving the sameocclusal prescription on an
implant as what you do would doa natural tooth you're
potentially introducingcomplications further down the
line.
So this is why I'm saying is uhand and do you do you see what
I'm talking about here now Jamesis is that this level of depth
(25:19):
of knowledge is not increasingchair time it's doing simple
things like changing the depthof an implant at time of
placement it is choosing acertain connection type certain
diameter writing certain thingsin in the prescription so the
chair time is the same or lessbut your outcomes are vastly
(25:40):
different.
This is and this is why I'm I'mso passionate about it.
Dr James (25:45):
This is why I believe that we should be understanding
this on on on so on such a depthyeah I mean it's it's the the
reason why this is mainly soimportant is to get the b the
best outcome for the patient andeverything else flows from
there.
Yeah so here's the second thingthat happens you get all of
this right less chair time whatdo we want as you get less chair
(26:10):
time less pain uh less fewercomplications uh uh uh fewer
remakes all of that good stuffall of that good stuff greater
efficiency which is good foreveryone on every level there's
no downside to that yes nodownside you know there's not
even a sacrifice in terms ofspeed versus outcomes they're
(26:33):
actually synergistic it'sactually both these things and
it comes back to knowing thestuff that you've said and this
stuff uh do you believe thatthey go to this level of detail
in your typical masters I guessno no and how do I know that
because several of my delegateshave got master's master's
degrees and they all said thesame thing they all said look I
was taught the basics prettywell but I thought I would be an
(26:58):
expert in everything by thetime that I graduated and I
turned around say to them thatyou're not alone because I
thought the same as well.
And this isn't this isn'thaving a go at master's degrees
this is this is reframing itright that everybody's
assumption when they start amaster's degree is is is twofold
firstly you will be an expertby by by by the time you come
(27:19):
out and secondly patientsactually care about these
letters after your name and theanswer to both of those is no
not really you know you saidsomething really interesting
once and I always meant to askyou about this and I feel like
it's relevant to thisconversation so let me ask you
now I remember we were talkingonce or perhaps you were
(27:39):
possibly speaking in front of aroom as well and I remember you
saying this and we were talkingabout the the uh career path of
an implant dentist right like ifyou want to uh propel yourself
or you want to progress furtherdown that path right so it
starts out single tooth multipletooth then maybe all on four or
something like that you knowwhat I mean and again it doesn't
(28:02):
look like that for everybodybut okay that's your typical
progression and I remember yousaid something really
interesting and you said youknow what I used to think all on
four was a pinnacle but now Iknow it's not even close.
Dr Pav (28:12):
Yeah what did you mean by that I mean it it is such a
varied and diverse field is it'skind of where it's it's it's
like where do you stop right soyou go from uh you go from all
on four to uh and and then yousplit it down are are you
talking uh uh fp3 type uhprosthesis which is your typical
(28:36):
what you see all on four or areyou talking like uh FP1 uh
prosthesis which is basicallyjust replacing the teeth okay
then there's like okay well um Ican't get the implants in the
right position uh we need tostart doing pterygoids then you
get good at pterygoids then youneed to look at transnasal
implants then you start lookingat zygomatic implants then you
(28:56):
start looking at subperiostealframes and once you can do all
of that you know what yourfavorite case becomes that
single implant out of the smilewhere there's plenty of bone and
you know it's going to take youfive minutes to do.
So that is the full circle thatis the full circle you
constantly want to be I want tobe able to do this complex work.
I want to be able to do thiscomplex work.
(29:18):
In order to do the complex workyou have to be able to deal
with the fallout part from it aswell.
And again on that full archthing and this again goes back
to diagnostics treatmentplanning and understanding
everything is there is adisgusting overuse of FP3 where
people are just hammering thehell out of the boat.
Dr James (29:40):
And uh it's it it it is it's easy it's easy right the
other way to do it yes thereare fewer cases where it can be
done but even in these caseswhere it can be done the uh the
the the technical need from thesurgeon and the technician jumps
(30:01):
significantly so it's almost acase of damned if you do and a
damned if you don't because onone hand you have an easier
treatment plan but it'sextremely destructive but on the
on the on the flip side of thatcoin is you have a much better
outcome and treatment plan whichis technically more demanding
(30:21):
for you and your technician andthe truth probably lies
somewhere between in between youknow we're not Sith we don't
deal in absolutes the the thetruth probably lies uh probably
probably lies somewhere inbetween but then this goes back
to if you know uhbiomechanically what you should
(30:41):
be doing you can make theappropriate decisions you can
make the appropriate outcomesthat's what it comes down to let
me see okay interesting justprocessing that yeah fair enough
fair enough and um I don't knowI'm I'm actually I'm actually a
bit disappointed in myself thatI didn't get that star for Star
(31:03):
Wars reference right there thethe Sith dealing in absolutes I
must have I must have missedthat part of uh of Star Wars uh
but uh yeah anyway maybe maybethat's a feature kind of a
recurring theme of the the Sithversus the Jedi I don't know I
didn't know that one but thereyou there you go uh but yes
anyway no um thank you for thatpal thank you for shedding light
(31:24):
on that and you know I alsowanted to touch upon
communication given that that'sso important as well to all the
things that we mentioned earlierin this podcast I know that you
mentioned that a lot of thetime dentists aren't doing the
basics like addressing theelephant in the room like why
the patient is in a certainemotional state whenever they
(31:44):
come to see you and often thepatient can't really they almost
are not even aware necessarilyof why and you you can't just
say why are you anxious rightyou just have to say you can say
something like what's goingthrough your head or was there a
particular occasion in the pastthat made you feel a certain
way or kind of put you off beinga dentist or I don't know.
(32:07):
You know something like that.
The key thing I understand isthe patients they don't always
know why they feel a certain wayright so that's an example.
And then can you think of anyother methodologies or practices
that you have whenever it comesto communication that seem to
facilitate you doing reallygreat implant work.
Specifically with regards to uhanxiety or or relating to abuse
(32:30):
I think you know what I thinkgenerally and I think things
that how can they say thisalmost like if you observe other
dentists which I'm sure you dothrough your mentoring okay and
their communication styles likemaybe frequent clangers that
they drop that you that youdon't do or things that you feel
that if they address thesethings they'll all of a sudden
(32:52):
just become so much moresmoother whenever it comes to
their patient interactions.
Dr Pav (32:57):
So I've so I've I've I've got a couple of good ones
so first having confidence inyourself nice which goes back to
understanding biomechanicsproperly okay um but quite often
what happens is when dentistsstart talking to a patient who
needs to have a tooth removedthe way that they approach it is
oh once you have a toothremoved you can leave it as a
(33:18):
space you can uh have a denturea denture comes in one of two
forms you can have somethingacrylic which comes in and out
you can have something with ametal substructure you can have
a bridge a bridge is fixed inyour mouth it uh uh but you need
to it requires preparation ofthe adjacent teeth and then
almost flippantly at the end ohyou can also have an implant
(33:38):
okay firstly that hierarchiesbackwards okay from forgetting
patient anxiety forgetting forforgetting patient desires
forgetting fun and money all ofthat okay purely from a
biomechanical point of view oncea tooth is removed the next
best thing is is an implant endof discussion everything else is
(34:01):
one step back from that okay orseveral step backs from that
and the patients need tounderstand this if they don't
want to have an implant donethat's absolutely fine the other
thing that dentists mistakenlythink as well they mistakenly
think that we cannot offertreatment recommendations to
patients which is a load ofnonsense you are medico legally
(34:21):
uh permitted to say you know youneed to have this tooth out
there's nothing better thanhaving an implant put back into
its place.
The pros and cons of implantsare this here are your
alternatives that's it that'swhat it comes down to.
So I actually turn around andsay to my patients that you know
um uh purely from abiomechanical point of view I
(34:45):
know that this isn't in thecorner of your smile but it's an
important chewing tooth youdon't have to have it replaced
but my recommendation would bethat you have it placed there's
the you know can you see there'sa difference in that discussion
and then the other thing that Isee as well is is people turn
around say um oh I want to getstarted in implants but there's
not that many implants in in inmy practice is we just we just
(35:07):
don't do them.
I turn around say to them howmany teeth do you take out per
month oh between 15 and 20 likeright how many of these patients
are you telling they wouldbenefit from them from an
implant oh I'm not telling themthere's your problem there's
your problem you know if you ifyou if you've got good
communication skills and youtell 20 people uh uh in uh who
(35:30):
are having the tooth removed yesI know some people can't afford
it and there are certainpractices uh where the
demographic don't fit but inyour average practice either a
private practice or a mixedpractice a lot of people will go
ahead but I'm not recommendingpatients um uh to have treatment
done um purely for my for myown wallet I'm doing it because
(35:53):
I genuinely believe it's intheir best interest I had one
gentleman about six months agouh elderly um his teeth are
falling out from period uh he'shad simple dentures before in
the past absolutely hates themuh he told me he has the funds
for it he has the desire to doit um he was a little bit
(36:13):
anxious but I thought we cansedate him that'll be fine but
then he said something to me andI refused to do the treatment
for him and he expressed concernthat his wife's health is not
as well as what it should be andshe may need that money in the
future to be looked after.
(36:35):
And I quite simply turnedaround and said to him you know
what I don't think this is theright thing for you to do
because if it was me in thatsituation I wouldn't want to do
it.
So my recommendation to himbecame look there's a handful
that there's a handful of moreteeth that need to be removed.
Have a really nice set ofdentures made if you don't get
(36:58):
on with them come back to mebecause then we have more
options.
I said but if you do get onwith them fine that we you don't
need to have anything furtherdone so whatever we recommend to
patients have has to be intheir best interests.
Now a lot of people will turnaround and say well you're
shooting yourself in the footpav because you know you could
have done a really big goularchcase and that would have been
good income.
Yes it would have been okay butwhat I would rather happen is I
(37:22):
would rather be him be outturning around saying to his
friends and family oh you needto have a two three go see Pav
because he'll give you an honestanswer.
And honesty is it's it's itneeds to be uh further for uh on
the forefront of what we do aswell because without that
(37:46):
honesty aspect you know it'swith with my communication
skills would have been easy toget convince him to have the
treatment done would it havebeen the right thing for him
purely from a dental point ofview yes but fitting it into his
life and the other stuff thathad that he had going on
wouldn't have been the rightthing to do.
(38:06):
It would have been unethical ofme and I I didn't want to do it
so I actually refuse to do histreatment so this is where
communication comes in uh thatwe need to be able to have these
commun that these discussionswith patients and if you if you
have these discussions withpatients and if you're good at
(38:26):
communicating your biggestproblem is going to be I don't
place implants or I can onlyplace the basics I need to have
more training to do the morecomplex stuff you know you don't
have to become um purely uh animplantologist okay um that that
that's what I do okay I've gota handful of dentists where uh
(38:49):
sorry I've got a handful ofdelegates where that's all they
do they do implants they do theythey do nothing else but 95% of
my delegates they're actuallygeneral dentists and they
wouldn't want to step away fromthe general dentistry side
because they enjoy it too muchme I don't like it I'm not
interested in that the so Istick to just the just the just
just the implant side soeverybody's career and pathway
(39:14):
and progression is different andwe need to respect that but
whether you're learning implantswhether you're learning endo
whether you're learning orthoyou should be passionate about
it enough that you will neverstop learning I still learn I'm
going on courses this year Ihave my mentors that will never
stop uh uh uh never thatlearning will never stop for me
(39:38):
and I believe that we should allkind of like be the same in in
what in whatever field we wantto do even outside of dentistry
if you're in another professionyou should be passionate about
it because the the moreknowledge you have the more
skills you gain the more you cando things that other people
cannot do and you end up beingin a position where you have
less and less competition that'sthe way that I look at it.
Dr James (40:00):
Yeah 100% and you know you know on that actually
obviously this is the DennisonInvest podcast and people come
to me all the time and they'relike okay cool how can I be
financially free and definitelyinvesting is part of that.
Like obviously you want to haveyour pension and your ICIN and
everything along those lines butwhat actually generates funds
(40:21):
for the pension and the ICIN inthe first place yeah what's your
great you have two levers youliterally have two levers when
it comes to your investmentportfolio you can either boost
returns or you can boostcontributions.
Those are your only two levers.
There's literally one of thosetwo things and returns is a
function of the return of theinvestment the appreciation of
the investment manage the feesright so obviously you reduce
(40:44):
the fees and you boost theappreciation of the investment.
But when you know a little bitabout the stock market and when
you know a little bit aboutinvesting I mean it's very hard
to beat the market it's veryhard to beat the S P 500 okay
it's like is you know most fundsmanaged by professional
managers fail to do that.
So the odds of you doing thatare really slim like 3%.
I think it's like 3% of activefunds beat passive funds okay
(41:07):
and those are professionals yeahso what I'm saying is that when
you realistically you're onlygoing to really max out around
the level of returns of the SPsthe S P right so that's the most
that you can ever boost yourreturns.
Therefore you have to look atthe other lever which is how can
you boost your contributionsand what literally puts money in
the investment portfolio isyour skills.
(41:28):
And people don't get thatenough if you ask me I
personally believe that if youreally want to accelerate your
wealth journey you should lookat your cash flow and where that
comes from and part of that isbeing able to do really high
qual really specialist workbecause obviously it carries
more of a premium but alsoreally high quality and really
efficient which is actuallyexactly what this podcast is
about.
(41:48):
And honestly I feel that ifpeople got that and embraced it
that a lot more rather thancontinuously looking for an
investment edge they'd probablyget to where they want to go a
lot faster.
Dr Pav (41:59):
It's a mindset thing as much as an absolutely yeah
absolutely agree and uh anotheraspect on top of what we've been
discussing as well is um youknow uh Ivy sedation you know
quite simply is it it if ifpatients want to have implants
done they will be anxious aboutit um even if to me I know it's
(42:20):
going to take me five minutes toplace this implant for the
patient they're like well I'vehad a filling done before I've
had a crown done before but he'stalking about drilling into my
skull and psychologically theycan't handle that.
Well actually I can do it underIV sedation you'll be away with
the fairies you won't have theyou won't have a clue what's
going on.
Okay great now I'll have itdone.
So actually if you do asignificant amount of of surgery
(42:44):
and uh and implants I dobelieve IV sedation goes hand in
hand.
And then what happens is onceyou have that skill you don't
have to limit it to just surgeryyou can roll it out to general
dentistry.
You know IV sedation is afantastic and extremely powerful
tool.
Dr James (43:03):
Knowledge has been dropped on this podcast today.
Thank you Dr.
Pav Pav if anybody is listeningto this podcast and they want
to find you and talk to youabout anything that you've
mentioned today where are theybest off where are they best
able to do that?
Dr Pav (43:14):
Yeah so uh if you're uh somebody's interested in the
academy it's very simplyacademyofimplantecellence dot
com.
Uh you can find me on Instagramdr dot pav uh dotkera uh
there's academy of implantexcellence uh instagram uh
handle as well so uh lots ofways to to to to to to get hold
(43:36):
of me and and get in touch withme uh what I wouldn't say is uh
those who join the academy theytend to be and I've I've
mentioned before that I've gotpeople who've done master's
degrees but I've also gotcomplete novice novices
completely new to implants uhwhat they all have uh in in in
(43:59):
what they all have in common isa very similar mindset to myself
that actually you know what ifyou learn biomechanics you do a
better job the rest becomes easyand the business comes by
itself so these are people whowant to learn real biomechanics
so
Popular Podcasts
Betrayal Weekly
Betrayal Weekly is back for a new season. Every Thursday, Betrayal Weekly shares first-hand accounts of broken trust, shocking deceptions, and the trail of destruction they leave behind. Hosted by Andrea Gunning, this weekly ongoing series digs into real-life stories of betrayal and the aftermath. From stories of double lives to dark discoveries, these are cautionary tales and accounts of resilience against all odds. From the producers of the critically acclaimed Betrayal series, Betrayal Weekly drops new episodes every Thursday. If you would like to share your story, you can reach out to the Betrayal Team by emailing them at betrayalpod@gmail.com and follow us on Instagram at @betrayalpod and @glasspodcasts. Please join our Substack for additional exclusive content, curated book recommendations, and community discussions. Sign up FREE by clicking this link Beyond Betrayal Substack. Join our community dedicated to truth, resilience, and healing. Your voice matters! Be a part of our Betrayal journey on Substack.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com