Dr Stefan Abela is a consultant and specialist in orthodontics. He works at the world renowned Guys hospital in London and also is the owner of 128 Harley street dental suite – a boutique practice in central London.
In this episode we discuss:
– Lingual Orthodontics
– Healthcare Differences
– Purchasing a practice and patient transfers
– Where is Malta?
Can you tell us a little bit more about lingual orthodontics? Is that just a UK thing?
I would say that it is more prevalent in Europe. Lingual orthodontics has increased in popularity, but I agree with you that it is a little bit more complex than classic orthodontics. It’s usually placed indirectly so it’s all custom made. So you get custom made bases and custom made brackets that fit on your individual teeth. There are two main matting, so you can either use polyvinyl silicone trays if you are using chemical bonding or you can use transparent trays if you are using lighter cements. So following placement and bonding you have individualized arch wires and basically you have to go through the sequence to get the final results. However, I have to say that you always have to keep in mind what is and what is not achievable so ultimately, the treatment plan and the clinicians decision determine whether you have a successful or unsuccessful outcome.
Ive seen photographs of lingual orthodontics and they seem awfully painful to the tongue. Can you talk a little about that?
There is a period of adjustment for adults that is normally around two to three weeks, so what happens is that we usually tend to bond the lower arch first. There is a two to three week period where you will get some ulceration on the sides of your tongue and speech is affected a little bit. Younger patients tend to be a little bit more flexible. I had lingual orthodontics myself and I find that after the two to three week period the tongue adapts to its new restricted confines and eating and speech return back to normal.
So tell us about when you bought your practice. My assumption is that when you bought the practice, you walked in and the other doctor walked out. Is that how it happened?
Thats right! So what had happened is that the previous owner had left and just handed over their patients. The advantage would be that you automatically have work and an income stream, but what happens is that the patients automatically expect you to be pretty much similar to the previous owner. That is never the case. In my case, the previous owner was pretty lady, a blonde pretty lady with a completely different accent then mine. Besides from that, the patients will expect a certain type of approach, and a certain type of manual dexterity and handling and that doesn’t quite happen because we are all very different. I think the first thing that needs to be done in this situation is explain why the previous owner has moved but you also have to explain to the why you are the ideal person to take over the practice and how you are still very capable of achieving the results that they want.
What is the best advice you have ever received and from whom?
The best advice that I ever received was to always treat a patient as if they were a family member.
Can you give us one practice management tip/pearl that we can take to our practices tomorrow?
One of the most important things to look for is new innovations and new techniques that are available to us as dentists. So this will not only keep you abreast of the new technologies but will keep you interested in the profession. Sometimes we are enclosed in our offices and we tend to be a little bit detached from what is happening around us so I would say attend classes on a regular basis and attend conferences to meet your peers, but also be aware of whats out in the market, so that you are always one step ahead.
What technology really excites you right now?
I have introduced mini implants in my practice and I feel like that gave me a lot more flexibility when it comes to potential achievements and tooth movements. I see a lot of patients with missing teeth and mini implants are definitely a technique to use on these patients because tooth movement can be a little bit restricted in these cases so I feel that mini implants have given me that extra boost.
Can you give us an internet or app resource that you feel is truly awesome?
Strava – Running and Cycling GPS app
MyFitnessPal – Nutrition App
When it comes to dental apps, I feel that meditation apps can be quite useful. Sometimes they can take you out of it and give you that little bit of reflection and help you keep focused. One that I use is Buddhify. This one gives you meditation times of just five minutes each session, which is enough to take your mind off your daily activities and things that are stressing you out at the moment.
What would be the one must read book for dental people from your perspective?
If you had to start your practice all over again or you are talking to someone who is just about to start their practice, what advice would you recommend?
Knowledge is power, and having a great knowledge will give you a great foundation. However, you and I both know that Dentistry is not just about knowledge. If you are working it is also about patient management, if you own the practice it is also about entrepreneurship and business skills, and it is also about marketing. So what I tend to suggest and give advice on is, not only should you focus on your skills, but also be bit of an all-rounder.
How can we connect with you?
Website: www.128HarleyStreet.com
Email: info@128harleystreet.com
Jeffery
I’ve never heard of lingual orthodontics, but that’s super interesting! When I had my braces, it was the old fashioned way with – it’s exciting to see what new technology is coming out now. I will say though, the ulcerations on the tongue don’t sound super awesome. A 2-3 week adjustment period isn’t too terrible considering the time you’ll have them on for, but still, that’s rough.
I guess that’s the price you have to pay for nice teeth!