Stress in Dentistry 2024 – Life Changing Decisions – IC048

Protrusive Dental Podcast

THIS is the most impactful interview podcast I have published in almost 6 years of podcasting.

Do you resent bringing your work home with you (treatment plans, letters, CT scans)?

Do you struggle with work-life balance?

Do you have days where you feel unfulfilled?

The honest advice and mindset from Jorge Andre Cardoso might just change your career and YOUR LIFE. This is the real deal, Protruserati!

https://youtu.be/GJExz_vEH2w

Watch IC048 on Youtube

As Stress Awareness Month continues, we’re taking a close look at the challenges dentists encounter, from making clinical choices to achieving work-life harmony.

Protrusive Dental Pearl: Explore Jorge Andre Cardoso’s Cementation Guide. This resource allows you to access specific protocols tailored to your needs by simply selecting the type of abutment, retention type, and the cement restorative material you plan to use.

Need to Read it? Check out the Full Episode Transcript below!

Highlights of this episode:

• 02:39 Protrusive Dental Pearl
• 03:41 Catching Up with Jorge Andre Cardoso
• 05:50 Jorge Andre Cardoso’s Introduction
• 08:32 Practice Ownership: From Stress to Success in Dentistry
• 13:17 Balancing Clinical Work and Life
• 19:38 Education and Work-Life Balance
• 22:34 Embracing Diversity in Dental Practices
• 24:19 The Importance of Foundational Knowledge in Dentistry
• 30:27 Maximizing Practice Efficiency and Personal Fulfillment
• 37:44 Learning More with Jorge Andre Cardoso

For those interested in attending the Conscious Leadership Course this October or November, please act quickly.

Visit Soft Bites online to learn more from Andre and Manuela and secure your spot.

If you are interested in joining a Protruserati cohort – please indicate your interest in Protrusive Guidance.

Got stress management tips of your own? Share them in the comments! just tell us about what was the most impactful thing that you gained from Andre in this episode.

Access the CPD quiz through our app on https://www.protrusive.app, either on your browser or by downloading our mobile app.

For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. Join us on Protrusive Guidance, our own platform for dental professionals. No need for Facebook anymore! 😉

If you love this episode, be sure to watch Dentistry is STRESSFUL with Manuela Rodrigues

Click below for full episode transcript:

Jaz's Introduction: Protruserati, this might be the most important episode I've ever, ever, ever made. I'm not exaggerating. It is Stress Awareness Month and what me and my guest, Jorge Andre Cardoso, what we cover is just amazing. Mostly him, his brilliance just exudes. And we cover such hard hitting themes that if there was one episode this year of Protrusive that you listen to or watch, make it this one.

[Jaz]
And please, please, please share it with everyone you care for in dentistry. Because the themes that we cover are things like bringing your work home with you. Do you suffer with that? I have for many years, I still do, out of choice. But for some people, they don’t want that. They don’t want that to be a feature of them as a dentist.

They don’t want to have to spend their time treatment planning while their children are waiting. We also talk about the frustrations of there being so many different ways to do things in dentistry. Like you ask one colleague and they give you some advice and then when you ask the second colleague, that’s when you’ve shot yourself in the foot because now you’re getting conflicting advice.

You are confused and that’s stressful. We also cover themes like how much holiday should we be taking and how many days per week should an ideal dentist, how should a day look like, actually choreographing your day to minimize stress. And in my opinion, stress is a funny thing. Like, we know we need it.

Stress is important for us to function properly and to respond properly to the challenges that we face. But at the same time, we know that stress is not good for us. Chronic stress is not good for your health. That is fairly ubiquitous in terms of advice that’s given. But at the same time, I’ve seen a TED talk whereby they say that actually, the stress is not as important as your perception of stress.

So if you think that stress is bad for you and that stress will cause you to have a heart attack, then you might do. But if you think of this stress as a good thing, and actually I need this stress, stress is a good thing, then some studies will suggest that actually you don’t suffer with those perceived negative consequences of stress.

Isn’t that fascinating? The other fascinating thing about stress, when we’re talking to non dentists, I got lots of friends in the business world, in my little Afghani Sikh community, lots of people into business, wholesale, retail, that kind of stuff. And when I mention stress to them, when we talk about stress, they always perceive it as financial stress.

So when I say stress, what they’re hearing is, I’ve got a lot of bills to pay this month. I mean, the financial stress is a big one. And for some dentists, it could happen. And it can be an issue, especially when you have a young family, new house, new practice, and that can add to our troubles as well.

But the real stress is like patient complaints, and how you run the practice, and your procedural things, things not working, like those daily things which really do eat at us. And a lot of non dentists just don’t get that. Anyway, I just can’t wait to share this episode with you now, unusually for an interference cast.

This is the interference cast arm of the podcast, whereby we talk non clinical things. Lots of clinical goodness here as well. Now, usually I reserve my Protrusive Dental Pearls for PDP episodes, but I’m going to do a repeat. I’m going to give this as a PDP, but I really want to highlight it here now for you as well, because our guest, Jorge Andre Cardoso, he set up this amazing thing.

Now, I’ll talk about it in the podcast as well, but basically, if you’ve ever been thinking which cement or which cement family should I choose for my restoration? Like if you’re doing a specific type of crown overlay and what type of cements are best, what should I be using? So what Andre has made is on brainhands. net, there’s a cementation guide.

I’ll put the link in the show notes, but you literally select your type of abutment, your type of retention, like, is it adhesion or is it mechanical? And which restorative material you’re going to be using. Could be feldspathic porcelain or zirconia or lithium disilicate.

You just choose through all these. And then you click the button, get the protocol, and you watch the magic unfold in front of your eyes. It’s just a fantastic guide for any restorative dentist. It’s evidence based, and I just applaud Andre for what he set up with his colleague. I’m always here to shine a light on the good people and the good stuff in dentistry.

So, Protrusive Dental Pearl, check out the Brain Hands Cementation Guide. It’s free. I’ll also put a link to it in Protrusive Guidance, our app, and this episode will be eligible for CPD. More about that at the end, but I’ll catch you in the outro.

Andre Cardoso, my good friend from Portugal, Porto. I miss you so much, man. It was great to just catch up a little bit before I hit the record button. How are you, my friend?

[Jorge]
I’m very well. I miss you too. I was asking before we start, when are you coming back to Portugal? We had a great time last time.

[Jaz]
I miss you. I miss the Francesinha. I miss all the great other food that I tried in Portugal. There’s so many reasons to come back, but I appreciate you coming on the podcast again, my friend. Talk about a really important topic. It’s Stress Awareness Month. Did you know it’s Stress Awareness Month in April?

[Jorge]
Yes, I’m aware of that. Yeah.

[Jaz]
And I wanted to pick your brains because you are such a great comprehensive dentist. I respect you so much in so many ways.

[Jorge]
Thank you.

[Jaz]
And actually, a lot of episodes. I have a Protrusive Dental Pearl. And this one, although it’s going to be an interference cast, I never usually give a Protrusive Dental Pearl, but I actually want to give one today because I really want to highlight something epic that you’ve created.

I don’t think I’ve highlighted this on the pearl before. But the on brain hand, you have that cement selection thing. Absolutely mind blowing. So if anyone’s listening, watching this right now, the protrusive pearl of this episode basically is I’ll put it on on the link. Everyone, any doubt you ever had about which cement should I use?

You literally choose the type of restoration you have and then conditions and it will tell you which cement and also give you the clinical evidence. So I mean, that must have taken a lot of hard work to set up.

[Jorge]
And sorry to interrupt you, something very important. We also give a very small selection of dental materials that you can use and all of them, we want to do like a very small amount of materials and none, there is no commercial interest. All of that is only based on what we believe to be reasonable and evidence based and there is no commercial interest and it’s free to use.

[Jaz]
Yeah. I mean, I’m just blown away. So every time I see some colleagues and I referenced your work and I say, look, check out Andre, check out this website. It’s up. And then they love it. They all log in. So I want to just share it to the wider audience as well. But I want to talk about stress awareness. And then before we dive into all these questions I have for you to really help us to share our stories and overcoming different points of stress in our careers and giving tangible advice for everyone. Just for those people who haven’t come across your work before. Tell us about yourself, Andre.

[Jorge]
Okay. So basically I graduated in 2002. I worked as an associate for three years. And after that, in 2005, I opened my own practice. That was a very stressful year, very stressful year from the opening my practice, because at the same time I was doing a master’s degree in London.

I think I eat depression, maybe not clinically detected, but I was really, really anxious at that time. And it was very difficult for me because I opened the practice because I wanted to do international publications. That was the reason. So I wanted to have control of the environment to be able to photograph and have all the materials.

But I forgot that you have to pay the bills as well. That’s not a game, you know, you have to pay the bills. So when you have to pay the bills, if you open a practice, that might not be the best strategy. It was very stressful, but then I learned, basically I learned how to manage a team. I just read, I just went to courses.

There was a big influence from a friend of mine called Aalok Shukla from the UK. And he basically brought me out of a black hole, which was, I was completely unaware of how you should manage people because my father has a restaurant and he micromanages everything basically, which is not a good idea in these days and because things have changed dramatically.

And we’ll talk about that. The way that you manage a person today cannot be the same as the way that you manage a nurse 10 years ago, or even five years ago, things are completely different. So I meet to a lot of education. I do a lot of education of courses and stuff. We did together a course in Portugal, and I really hope to collaborate with you in the future.

But in order to do that, I had to get my practice in order in terms of protocol systems, management, philosophies, culture. So basically, my goal is to do a lot of education and in the future, I want to have six months of vacation a year. That’s what I want. That is my goal. So that’s not easy.

[Jaz]
I love everything you said. I love that you shared that goal. And I also admire Andre the honesty that you’re very honest to say that your reason for opening a clinic, I think it’s very nice that you shared that with us and your honesty and then the challenge that brought you. And actually, Andre, you need to join Protrusive Guidance.

I want you to join Protrusive Guidance on our app and just start engaging in our community because you just have so much experience and background, like Marie recently is one of our colleagues, Protruserati Marie. She posted on the app recently that she’s thinking of acquiring a practice and she asked about like red flags and what are the questions to ask and stuff.

And there’s so many, we’ll consider at some point, opening clinics. So before we move on to top attacking this topic of stress, as you said, opening a clinic, starting in the clinic is a very, very stressful thing. What’s the number one advice you would give to someone who’s acquired a practice and is really feeling that stress?

Cause it’s like your baby. You have to give it all your attention. Every waking breathing moment is someone who’s in that very dark place because of the practice ownership. What advice would you give to them?

[Jorge]
Well, a couple of things. So first of all, before all that, before even you buy a practice. If you haven’t bought it yet, ideally, you should ask this question. What is it that you want to do in 5, 10 or 15 years? And really take time to think about that. That can be through meditation, time alone. Just take a couple of weeks, maybe sometimes a month to think about that deeply. What do I want? And what you want now may eventually change in the future. But what is more or less your idea?

My idea was to open the practice to do publications. So that would be a goal. So now after, so you have the practice. So a couple of things, very important. Number one, do your math, be very accurately with numbers. You have to really know what you are spending, not on a year, not on a month, every single day.

You have to know the fixed costs that, so per day that passes by, what is the amount of money coming out of your pocket? Because there is, in my opinion, there is no more important decision that you can make because if you know that number, it will create the cascade of events and thoughts that will force you to be responsible with finances, which I was not.

Why? Because I just want to have the best material spent two hours with a patient to take photographs. It was very difficult because there was a point in time where I had to borrow money from my parents. Parents to pay part for the master. It was extremely, extremely stressful for me because my parents, they basically provide me the course, they provide the education.

So they started from nothing. No, I had everything. Why did I have to borrow money from them to pay part of the master? Why? Because I was not completely money aware and that’s really, really important. So you can do whatever you want in your practice, as long as you are financially aware of what’s going on on the daily basis.

Okay. That’s number one. Number two, have written systems for every little thing. Everything phone answering sterilization, composite feelings, endodontics. So imagine that you want to write a book about your practice with every single detail, the same thing that’s happened, like say in McDonald’s or the Ritz hotel.

So basically everything is written down. Okay. And number three, the final one, I would go for. Emotionally intelligent for dealing with other people. I would learn as much as possible about emotional intelligence, leadership, emotional regulation, communication, all of these, let’s say soft skills. So I think those four things would be really, really important.

So know what you want, do the math, have system written down and learn about emotional intelligence, soft skills, and whatever you want to learn. So you have to do these four things simultaneously while pursuing your goal. Because my goal is to write in publications. Your goal may be, okay, I want to buy a practice because I want to sell it in the future.

My goal would be, I want to buy a practice because I want to control my schedule, that’s a reasonable goal as well. My goal is I want to buy a practice because I want to make a lot of money. Whatever the goal is, these four components, they need to be present. This is my opinion. Yeah.

[Jaz]
I’m so glad I asked you this off script because this wasn’t part of our script. I’m so glad because that is just an absolute gem. I’m going to make that into a reel and share with everyone because that was just absolutely fantastic. And so just a couple of reflections on that. You mentioned day rate. A lot of people talk about the hourly rate as well. When you start thinking about how much it costs per hour to run per surgery, it’s really, and one of my friends, Koray Feran, great, great, great dentist in the UK.

You might know him actually. He talks about how practice owners, they have the fear inside them and perhaps sometimes as associates, I can speak as from associate that we don’t have that fit. And it’s not that we lack ambition. It’s just that we’re completely seeing it from a different frame of mind. And so sometimes it’s good for associates to put ourselves in the principal’s shoe, but also the vice versa.

So that’s an important thing there. The other thing you mentioned about systems protocols. I love that you said about, McDonald’s, Ritz, everything is standardizing excellence. How can you ensure that when one of your associates does something, it is just as brilliant as when the other associate does it or how things are sterilized for everything.

I love that the whole thing about protocols, including how you do composites, how you manage perio in the practice so you can really scale excellence, right? It’s about scaling excellence. And the last thing you mentioned. It’s about emotional intelligence that all relates to staffing because the number one stress.

All my principal friends tell me is staffing and people. So I’m just blown away that you said all those things to actually tackle the questions I had for you today, Andre. The first thing I want to talk about is you may remember a while ago, we talked about comprehensive dentistry and making comprehensive plans and using make me clear.

Fantastic. Another wonderful thing that you set up in terms of treatment plan presentation. You said this thing to me. You said, the worst thing that can happen to you is that you become successful in comprehensive dentistry, because when that happens, like, it brings so many challenges and problems, but it’s a beautiful thing.

It’s a beauty. It’s quality problem. As Anthony Robbins says, it’s a quality problem to have, but it made me laugh at the time. It’s like you’re so true. The worst. What’s the worst that can happen? The worst that happens, you actually become successful in comprehensive dentistry. Now I’ve been thinking when I started to become more comprehensive, one thing that I had to sacrifice, which a lot of dentists may not be willing to sacrifice would be the following.

The fact that I had to bring my dentistry home with me. I had to look and stare at photos and think about people’s cases at home in front of laptop. When I could be at that time, I didn’t have kids when I was starting stuff, but like doing all the things that you could do. And some people are just not prepared to do that.

I feel as though in this day and age with the way that we work in dentistry at the moment, and maybe you’re going to offer some suggestions of how we can overcome this, but to be comprehensive, to do the kind of work we want to do. We have to bring our cases home. We have to do a lot of thinking at home.

We have to do a lot of posting of our cases, emailing patients, treatment plan, stuff doing at home. And this is a big source of stress. I feel as though my colleagues who have partners who are dentists, spouses who have dentists, they get it, but then there’s a lot of friction and problems who are dentists, who have spouses who are not dentists.

They’re like, why are you constantly bringing this home with you? So I guess my question to you, Andre is, do you think there is a way that we can still be comprehensive? But not have to bring our cases home because I think that is a source of stress having to bring work home with us.

[Jorge]
So I’ll answer but before that I’ll answer another one. Number one is Can you not be comprehensive today? I don’t think so. I think it’s very difficult. Maybe NHS base or public health system base, you can do that. But the thing is that everything is multidisciplinary. Everything is comprehensive because now you have a 50 year old male that understand that before the veneers, you should do Invisalign and you have to do some perio for recession and then some implants.

So it’s very difficult that you say, oh, I’m not going to be comprehensive. So the thing is that If you think that comprehensive and this is not for you think twice because it’s coming to get you, number one. Number two is I thought about a lot about this. How can we manage this need, this absolute need of bringing work home?

You have to integrate at least partially that in your working hours you have to integrate that. Because the thing is that while it is delegatable you can delegate sometimes lab communication in some aspects you had. You can do some of that. In some aspects you can delegate some lab communication, but for treatment planning, you have to do it yourself.

There’s no other way. So I would integrate that. I would integrate that in your clinical hours. My personal take on that would be, and this can be difficult for some people, would be to have a conversation with your family. Say, look, there’s part of my work that I have to do at home. I’m trying to either start later, at the practice or come early and I will do some work at home.

Or ideally, you should leave the last couple of hours, at least one hour at the end of the day to take care of that while you are still in the office, it depends on what works best for you. But I thought a lot about that. There is no other way except integrating these, which are working hours within your working hours at home or in the practice.

Now this might be scary. Why can it be scary? Because, well, but I’m not making that much money. The thing that comprehensive dentistry can eventually scare you is because it seems that you are not seeing as many patients per day. As you were with single tooth dentistry, but that will eventually catch up and you have to realize there’s no other way of running away from it.

Yes, you may have a lot of your work that is single tooth dentistry, but like I was telling you, you have to face the fact that comprehensive dentistry is here to stay and you have to adapt yourself. And one thing very important, which is that the price of comprehensive dentistry is not proportional to single tooth dentistry, which means like, for example, six crowns, six individual crowns could be six times plus the price of crown.

When you are doing full mouth rehabilitation, you cannot say like, oh, it’s 10 or 20 crowns, 20 times the price of a single crown. You have to integrate a lot of things. You have to add that to the cost of provisionals, sometimes one or two sets of provisionals. And also, reflecting time or treatment planning time.

So the price of comprehensive dentistry is exponential. It’s not proportional as it is single tooth dentistry. So sooner or later you will have to charge more. You may initially charge less because you don’t feel very confident, but sooner or later you have to see that you have to charge more because the price will skyrocket in terms of provisionals, breaking of provisionals. Time that you spent in front of the computer. So you have to accommodate all that.

[Jaz]
Thank you, Andre, for that. I’m just putting myself in the shoes of, I’m an associate, but I’m just thinking if you are in the wrong environment for comprehensive dentistry, then it’s a total loss already. You’re really in an uphill battle, but I’m just trying to think like, sometimes you as an associate want to be comprehensive, but the environment is not quite there.

And so we need to really mold our environment. And so the advice I would give is imagine you’re an associate. It’s very difficult to have that conversation with the principal and say, hey, actually, between 11 and one, I’m going to block my diary and not see patients and not generate an income for the clinic for you, because I am thinking about cases.

I’m doing some lab work. I’m doing that kind of stuff. As an associate, you don’t really have enough bargaining power when, like we said before, the principal knows their numbers. We have an hourly rate. So I think the advice we can give is if you’re in the kind of environment where that’s difficult to achieve to do what you said before, which is come in an hour earlier, stay in an hour later if your goal truly is not to bring it at home because you can’t overcome that.

And the other thing about it actually is education because when we qualify for dental school, we are nowhere near being comprehensive. And so we have to do courses and reading and learning. And you know what? I think there’s no shortcut for that. I think the first five years, first 10 years and forever really, we always need to dedicate that time to do it.

So again, where do you find that time from? So my next question that leads into this is Andre, how many hours per day and how many hours per week and how many days per week kind of thing you think is a good mix between actually being in someone’s mouth. And doing the education, the treatment plans, the non clinical, without losing our sanity.

[Jorge]
I think that the percentage of that, in my personal opinion, would be between 10 and 20% depending on how deep you are in your story into comprehensive dent. For example, I do a lot of comprehensive dentistry. Mine can be about 20% of my working time. In the beginning it can be like 10%.

[Jaz]
So what you’re saying is 10% of your time goes towards comprehensive dentistry? Is that what you mean? Sorry.

[Jorge]
No. 10% of my time works is for outside of the share work, which is education and treatment planning and everything between 10% and 20%.

[Jaz]
Got it. And then therefore, how many days per week should you be clinical?

[Jorge]
So I would say that I think that four days would be maximum for your own sanity. And the final day of just education and treatment planning. I think that’s a good relation, four to one.

[Jaz]
Yeah. I think that’s good. And I think a lot of people say, three and a half and whatever works for you in your phase of life, right? There’s different phases of life and it’s a conversation that you need to have your family as well. And sometimes you tell the family that, okay, I’m going to go in an hour early and come back an hour later so I can do the treatment plan stuff.

But then also, these courses and some education time that you need, if you have this knowledge gap that you’ve identified, this skill gap, and sometimes it involves dialogue and emotional intelligence and conversation with your loved ones, who, especially if they’re not in dentistry, to understand what you’re trying to achieve here.

[Jorge]
Okay, so one advice would be tell the practice owner. Look, I am starting to this comprehensive dentistry journey. Just give me give me some time to do proper initial examinations and let’s see the return of that financially within one or two to the old way. But let me just give some proper initial examination and proper treatment plan presentation.

Give me space and time for that and in the beginning, I am learning. I don’t want to be paid over that. Just give me some time and if results happen, we’ll go this path. If not, we’ll go backwards. This way, you will be offering, you’ll be doing like a, a irre fusible offer to the practice owner.

[Jaz]
I think the lesson here and what we’ve shared in the last couple minutes is there needs to be a dialogue with lots of people, your family, your principal, and you can’t just expect to change something about how you practice and your goals without sharing with the universe what it is you’re trying to achieve.

When you start to let people know your intentions, then you can actually break down the barriers and actually work in a common goal. So I think that the main tip there is okay. It’s great to have these aspirations, but don’t just keep it in your mind. Speak out loud and discuss this.

Try and seek a win win with family. Try and seek a win win with loved ones. Try and seek a win win with your practice principal and your practice and your nurse, even your nurse. Everyone needs to be in on it. You can’t just do it alone. Now, speaking of doing things alone and then collaborating.

One source of stress that I always had when I speak to our colleagues, a constant source of stress is the following, whereby there are so many different ways to do anything like I thought in restorative dentistry, we have so many different collisions and different viewpoints and techniques and ways to do things.

I thought restorative dentistry and occlusion. I thought that was very controversial. Then I did a diploma in orthodontics and I was like, oh my goodness. Orthodontists can hardly agree on anything, right? Like there’s so many different school of thoughts in orthodontics. And that really opened my eyes.

Like, wow, there really is so many ways to do things. I remember when my educational supervisor, Raj Ratan, many, many years ago, he asked us a question. He said, what would you prefer? Would you prefer that everything was a rigid system, and if you want to do a composite, there’s always this steps, and that’s how you do it, and there’s nothing else, and that’s how you do it?

Or, do you prefer a system whereby, actually, you can pick and choose, and there’s a bit of ambiguity, and most of us, and we were like one year qualified, most of us, put our hands up for the rigid one, because when you’re a newly qualified and you don’t even know the foundations so well as well as you want to, you kind of want a recipe book.

We actually crave a recipe book. When you don’t have experience, when you don’t have enough knowledge, you want a recipe book. But when I started to change my mindset and my perception, actually the beauty of dentistry is that we can do things in so many different ways. And if we take that away from us.

Then our proficient actually suffers. And I actually started to enjoy my dentistry more when I started to see the beauty in this, but the problem happens. Andre and something I saw on your instagram page is when we seek advice from a colleague, a mentor, and then we seek advice for that same case from a different mentor.

We get different opinions and that can be a source of stress. So my question to you, Andre, is how have you managed this in your mindset, in your career, in your stages of learning that actually sometimes there are too many chefs and too many chefs spoil the broth? How do you think about this?

[Jorge]
So I think this is really tough one because I think that dentistry starts with a lot of complexity and then you just start to funnel it, funnel it, funnel it to create your own ideas and your own protocols. So I’m sure it in the beginning for occlusion for you was completely different and now because you teach about it, you have in your mind the paths, the guidelines, and it’s much easier now. My recommendation for that would be to resist social media education in bits. I would go and read the classics. I would go and read Dawson.

I would go and read Magne. I would go and read Lindhe. I would choose three or four big books where you would start. Perio, I started with Lindhe. You don’t have to read the whole book, but just try to see whatever you have. Now just go and read that chapter. So Lindhe is for Perio. I would go for Dawson or eventually Okeson for occlusion, and then you can eventually disagree from Dawson in the future, but I would start with Lindhe for Perio, Dawson and Okeson occlusion.

Maybe read some, I would say, Fradeani to see the opposite situation in terms of occlusion. I will also read Pascal Magne in terms of biomimetic dentistry. And I will stick with the classics. In the first years of my career, this is what I did myself, because I am with you as well as you, you are probably, you remember the world before the internet and we had to use books.

So I would read the classics, but really the classics. I will read the classic of Perio, which is Lindhe and the classic of occlusion. And I will start from that. Then once I had those foundations, then I would go for bits of information and start doing some of the courses, because I think that for Instagram, there’s just so much things out there.

And I think this younger generation is used to learning by bits, by its soundbites. And this can be very addictive as we know. But for you and I, because we provide education and we had to read the classics, I’m sure you read the classics of occlusions, right?

[Jaz]
Absolutely.

[Jorge]
That is not very confusing. But if you haven’t passed by the classics, it’s completely confusing because you hear this and you hear that. And also there’s a lot of issues in pre-grad school because of lack of funding. And sometimes the preparation is really, really basic. So I would really go for the classics in the first years of my careers and then expand from there.

It doesn’t mean that you should always stick with the classics, but then you have the foundation where you can start to create and to filter your own ideas and where you are going to come go and find for the knowledge. Another thing, I think that even if you go online, I would go for structural online education, like what you do, like you have a structured online program.

It doesn’t have to be present, but there’s a structure for the person that created education, thought about the directly, the pedagogy. So there’s A, B, C, and D because I’m sure that when you create a course, you think about what will be the student experience and it’s a stair. So I’m not going to talk about the third step before going to the first.

So we’re going to first step, then the second model. Because that really is important today, because otherwise you’ll get confused, so you have to resist. Once, unless that you are in the position that you have very confident in your knowledge, then you can hear the soundbites and the small pieces on Instagram, which are important, of course.

And remember, for example, Marcus Vlatic does an amazing job with spreading education, but it’s small bits. It’s not structured. It’s heads and soles place, but I think that you should focus on the basics, the classics, and then go for structured education. And then eventually you’ll feel more comfortable learning from small bits of social media and sort of education, which is also important. Of course.

[Jaz]
I think your main point there is really make sure we nail the foundations and with the point you made about the structure and having structured learning where just like you said, when me and you make education, we think very hardly about, okay, first we need to walk before we can run.

In fact, me and two colleagues are writing a book called Problem Solving and Occlusion. Very basic one for the young dentist. And we’re thinking very hard about chapters. So before we talk about checking the occlusion, we’re actually talking a little chapter on articulating papers before we then the use of it on conforming with a basic composite before we then talk about a simple crown and how and then we talk about the onlay where things a little bit difficult to check the occlusion.

So there’s a stepping stone. And again, it’s the foundations and it’s right. End this question with the following quote. My friend Alan Matthews from Scotland, I don’t know if it’s his quote or not, but I quote it a lot, which is basically listen to everyone, but do what feels right to you. Any one stage in your career, you are a, as Zak says, a patchwork quilt of all your mentors and teachers and books that you’ve read at that moment in time.

And you’ll never have all the answers and you’re always a constant evolving clinician. But at that moment in time, just respect that. Okay, with the best information that you have at that one moment in time, make the best decision you can, and maybe that decision will be different five years later. And just be at peace with that.

But with the moment that you have, with the best available knowledge, whichever one feels right with you for your patient, go with that piece of information. When things get a bit confusing, when you’re not really sure which path to take, listen to everything, but whichever one feels right to you at that moment in time, and don’t stress too much.

If you get stuck on that decision, then you cannot move forward. And that itself is not a nice place to be. Before I ask the final question, any reflections on that, Andre?

[Jorge]
Well, yes. And I will add to that the fact that do the best with your current knowledge and with the current tools of the practice. Sometimes you only have this composite. Sometimes you only have this adhesive. Sometimes you only have this limited amount of time. So don’t stress about that. It’s always good also to work on depression the first year. So sometimes you may want to do like a layering composite restoration, but it’s just not within the budget of the patient.

It’s just not within the time limitations of the practice. It’s just not within the composite existing on the practice. So do whatever you have with the knowledge that you have and with the tools that you have at this point in time and just get over that. It’s fine. Just do the best that you can.

[Jaz]
I love it. Fantastic. Well, the last question I have is respecting stress awareness month and the real point of this podcast is just whatever different questions that we’ve asked and different things that you’ve given so much value today, different people will hear it differently depending on what stage of career they’re in.

[Jorge]
Absolutely.

[Jaz]
Any part of that where they think, you know what, this is a good strategy or good mindset process to come from to help reduce my stress. What do you think, Andre, of the themes that we haven’t yet explored? What is the number one thing that you want to now touch on as a final thing about, okay, this is a big stress issue in our profession and what tangible advice, actionable advice that you can give our colleagues listening and watching right now so that we can improve their lives in some way?

[Jorge]
I would say that if you are a practice solder, I think that you should surely considering think working in that practice. More, but improve the part that you work, that practice more than you work in the practice. So think about that. Think about how you can improve the practice and not spend so much time working in the practice.

So one thing is work the business and not work in the business. If you are an associate, right? When I mean working on the practice, it means the culture, the systems, the financial awareness. And also the emotional, so cultivate yourself as a person. Now if you are an associate, it’s the same thing.

Do try to work nonclinical stuff. Try to see how you can improve your education, how you can improve your communicating skills, how you can improve your treatment plans, how you can improve your comprehensive dentistry. And also work very seriously on your emotional intelligence. So I think that today we need to think more and more about that.

Now regarding the emotional intelligence and the mental health, I mean, there’s something that I think that it’s really important to say in this podcast, which is, and we are all different, but I see one very common thing, which is I see a lot of exhausted colleagues because they work in excessive amounts of hours.

I think that taking time out of work, either for family, for vacation, and very specially for exercise and for do some sort of activity that you like. It might not be exercise, but just do something that you like. Most often than not, it involves exercise like outdoors activities. I think this is really important.

I think that we are forgetting the importance that being outdoors gives to you, even if you are not aware of that. I mean, go for a walk in the park, stay more time with your son. We believe that is just something that is okay, I’m not working. I’m just spending time with that person. I’m just spending time outside.

I’m just surfing. I’m just traveling. But the fact that it’s in your brain and your soul is unpayable. There’s nothing that can pay that. And I think that today we finally start to see, especially after the pandemic, this shift, which is people are realizing that life is not about work. The most important things in life are not only work.

Work is an important part of life for your self expression, for creativity. But if you don’t balance with the most important thing of all, which is human connection. With others and with yourself. If you don’t focus on that human connection with others and with yourself, because if you are not well connected with yourself, it’s very difficult to do human connection with others because the life as people used to say, which is it’s not about the goal, it’s not about the journey. But the most important thing is about the people that come together with you. Because that’s-

[Jaz]
I was just going to say this. Cause I was just going to say that, Andre, you taught me two years ago. You said this quote. I was literally just going to say, you stole it from our mouth. I was going to say that you’re the one who said that life is not about destination.

It’s not even about the journey. It’s about the people. And you just said it right there. And I absolutely love that. And actually recently on our Protrusive Guidance app, one of our colleagues, she sent a message, if you have a chat function and she sent a message, do you guys sometimes feel like giving up?

That’s all she said, right? And you could just tell she had a tough day at the clinic, right? You could just tell right? Yeah, and the outpour of support and resonating with that and advice that’s been pouring in the chat. It’s just been so heartwarming and and one thing that I offered it’s been absolutely brilliant and then having physical exercise and physical walking and that kind of stuff is mentioned a lot one thing that I use a lot which mean my wife both use a lot actually this technique is we always need to have our holidays booked a year in advance.

So I know exactly what I’m doing in June. I know what I’m doing in October. I know what I’m doing in December and I’ve got these booked out. And it is so nice for the mind to know that, okay, you know what? Sometimes things get tough, but you know what? We’re almost there. We’re going to have a nice break and just rather than when things get so stressed and you burst and you don’t have anything booked, you don’t have something booked, it’s not a nice scenario to be in. So regular breaks that are purposeful are for me as an important technique for me.

[Jorge]
Yes, absolutely. Because it’s something that you look forward to on a regular basis, on a regular basis, and let’s be honest here, dentistry, it’s one of the most stressful situations for a variety of reasons, but basically you are dealing with, my friend Aalok Shukla says this dentistry is a bunch of it’s one scared person inside four walls, together with a group of people with sharp instruments.

So, this is as stressful as it can be. Doctors, they treat patients, they do delicate procedures while patients are asleep. We do delicate procedures in a very sensitive part while they are awake and they have expectations, they have pain, they have insecurities, they have I mean, it’s really difficult.

So dentistry is you have, it’s like a high performance athlete. You have to see yourself as a high performance athlete and performance athletes, they have time for sleep. They have time for eating. They have time for exercise. I mean, you have to understand that there’s a lot of time outside the practice that you should really used for recovering and human connection.

And even in the practice, I mean, what’s the point of treating a patient if you don’t have a human connection with a patient? What’s the point of opening a practice if you don’t like yourself? So work towards liking yourself, work towards connecting to your self, because at the end of the day, nothing of this makes sense if you don’t connect with patients, if you don’t connect with family, if you don’t connect with staff, if you don’t connect with other colleagues.

It’s all about connection. That is the ultimate goal. So let’s never forget that. The ultimate goal. Yes, you can make money, you can have a family, everything, but you should connect with these people. That’s the main goal of life. It’s about human connection. It’s not about anything else. So use your success, use your creativity, use your business, use whatever you are doing. Use your education to make better human connections, to help other people so that they can help you. Because at the end of the day, that’s all that there is.

[Jaz]
For those listening on Apple and Spotify, you’re not seeing that I’m smiling. Everything you’re saying, I’m just smiling away, because despite the fact that my son has walked in and he’s sitting there, despite the fact that my mum has walked in a few times, right?

This is probably, I’m going to say, the most fun I’ve had at a podcast. This is the most impactful podcast. I think I’m probably a pleasure to be involved in Andre. Honestly, I’m so happy. Thank you. We’re covering this topic. And I’m making notes on the back of this, this card that was given because I couldn’t find my paper.

I’m congratulating us about a son one year ago. So just past the mishmash and me being in my PJs recording this, this has been a great podcast. One of the best podcasts, one of my biggest contributions, thanks to you, to dentistry. Thank you so much for this. I am just, I can’t wait to get this out for Stress Awareness Month.

Andre, how can we learn more? Because you need to tell us about the Soft Bites podcast that you and Manuela, unfortunately Manuela couldn’t join us today, she’s absolutely brilliant. But also, tell us about the retreats and the courses, because the retreats are exactly this topic. Please tell Protruserati, I really wanted to learn more from you.

[Jorge]
Okay, so basically, once a year, sometimes twice a year, we do a retreat in the south of Portugal, in Sagres. It’s called Conscious Leadership Course, and it has these two components. I’m much more of a rational person, and Manuel is much more of an emotional person. So, basically, I teach a lot of systems and protocols and tips, and Manuela in mindfulness.

So, it’s four days that we have in an amazing environment. It’s very informal, so we help each other, we give the lectures, we do some meditation, some other activities, and we think about the struggles in dentistry, and we provide some mechanisms and tools that you can implement in your practice right away, and we give all the templates, all the formats that you can eventually use right away.

So the next one in Sagres will be on the 3, 4, and 5 of October, that weekend of October, in the South of Portugal, this year, And we also have one upcoming in November in Amsterdam that we were invited to give, but you can go to softbites. online and stay tuned for more information, softbites. online. It will be lovely to have you there. And it’s basically about at the end of the day, using dentistry to fulfill, like you were saying the most important thing in life, which is being good with other people around you and being good to other people and use dentistry as a means for that. Okay?

And of course, that for all that you need to have the financial success. You need to have the time offs. You need to have the exercise, but at the end of the day, lose all those things as a creative way to give more and more of yourself to other people.

[Jaz]
How many people do you typically plan to have in the retreat?

[Jorge]
We don’t, usually don’t accept more than 12 people. That would be maximum. But usually what we have is about nine because we want to, basically, we go to dinner. We have some drinks at night. We go to the beach.

[Jaz]
I can tell you guys now that Andre looks after you, looked us after. What was that drink that you got for us? What was that drink that you introduced me to? It was like a, was it lemon flavored? What was it?

[Jorge]
Oh, limoncello.

[Jaz]
Limoncello, but no, but it was Limoncello, but it was a Limoncello, Mohit Sangria. Yeah, yeah, yeah, yeah, yeah. I mean, I can vouch for your hospitality for sure. But you know how last time we talked about digital VertiPreps, right? And so my team will put a thumbnail up for that. And we’ll put a link for SoftBites. online, but also that VertiPreps episode we did. But based on that episode, we kind of were just chatting like, hey, we’re going to come to Porto, right?

And so in the same style, I would love to organize 12, 15, whatever people, basically, Protrusive community to come and do the retreat with you. I would, I think it would be great. I’m always looking to like host a conference, something like that. But I think to do a small numbers and something so meaningful and so, so big.

So maybe this will be the birth of that. So I’m going to put something in the show notes, a link to register interest, to go and learn from Andre and Manuela about this retreat, because I think it’s just much needed in dentistry. But for those of you who are looking to go in October, November, please don’t delay.

Check out SoftBites online, learn from Andre and Manuela, for sure, great people. And honestly, I’m just so grateful for you giving your time to talk about these kind of things with us.

[Jorge]
Well, thank you so much. It’s always a pleasure to talk to you. And now go and play with your son.

[Jaz]
I’m going to Easter holidays. You should see him. He’s just looking, he’s just climbing the window there. Look, look, look. So anyway, it’s close. Thank you so much, my friend. God bless. And I can’t wait. And hopefully I’ll be there with the Protruserati on this retreat with you learning mindfulness with Manuela and learning efficient systems with you, my friend.

[Jorge]
Yes. Thank you so much. Take care.

[Jaz]
Well, there we have it, guys. I told you that that was a good one, right? I hope those themes that we covered really resonate and they help you to make some decisions, have some important dialogue, have some important conversations, get you to think about how you choreograph your day with intention, have some sort of goal in mind.

I’d love for those of you on the app, Protrusive Guidance, under this episode, just tell us about what was the most impactful thing that you gained from Andre in this episode. I want to thank you guys, part of the Protrusive Guidance community, just for being the nicest and geekiest dentist ever and making our magical little community what it is.

Do check out Manuela and Andre’s podcast, Soft Bites, for more of this kind of stuff. And if you are interested in going on a retreat with Andre and Manuela as part of like a Protrusive cohort, then probably in 2025, I think this could happen. Haven’t asked my wife yet. So I haven’t got level one permission, but I’ve been true to my word in the past.

Every time I’ve said on the podcast, okay, hmm, I’m going to go here. Be it AES or be it the Porto. We went to see Andre for Verti Preps. I made it happen. So I’m earmarking 2025 sometime when the weather’s good in Portugal. Let’s go on a retreat with Andre and Manuela. And the way that you can signal to me your interest is by DMing me on Protrusive Guidance.

Don’t do it on Instagram because it won’t get I mean, yes, we look at Instagram, but it’s managed by the team. Please DM me on the app Protrusive Guidance. Head to protrusive. app. If you’re not on there already, please get on there. It is the nicest and geekiest community of dentists in the world. So I want you to DM me on there and tell me, Jaz, put me on this wait list or this interest list for this four day retreat in Portugal with Andre and Manuela.

And of course, if you want to go sooner than that, then just go. I think they’re doing later this year, 2024, they’re doing some retreats. Go to it. But if you want to go as a protrusive cohort, maybe this year is not a good year for you, then signal your interest to me and I’ll put you in our little list.

Please don’t forget to share this with a colleague. If you think that it’s profound and it’s helped you, it’s likely going to help your colleagues as well. As part of Stress Awareness Month, please do share it with a colleague. Thank you so much for listening all the end. Once again, this is Jaz Gulati signing off.

See you same time, same place next week. Bye for now.