Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1513 Dr. Suresh Shenvi on the Evolution of Dentistry in Developing Countries : Dentistry Uncensored with Howard Farran

1513 Dr. Suresh Shenvi on the Evolution of Dentistry in Developing Countries : Dentistry Uncensored with Howard Farran

12/3/2020 4:00:00 AM   |   Comments: 0   |   Views: 590
Dr. Suresh Shenvi has worked in the V. K. Institute of Dental Sciences, KLE University, India, as a faculty in the Department of Conservative Dentistry and Endodontics since 2012. He has cleared many exams in India along with NBDE and ADAT in USA. He is the co-author of many top selling books for Indian postgraduate entrance examinations. He is a national speaker and resource person for keynote sessions and workshops on Endodontics. He is also the key opinion leader for Orikam Healthcare Pvt Ltd. He is a well sought motivational speaker and career counselor for dental students. He is a blogger and a youtuber with a channel by the name “ASPIRE32” with the aim to help people learn Dentistry better and has a wide base of viewers all across the world.

VIDEO - DUwHF #1513 - Suresh Shenvi

AUDIO - DUwHF #1513 - Suresh Shenvi

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Please excuse any typos as this was digitally transcribed.
It is just a huge honor for me today to podcast interview Dr Suresh Shenvi DDS MDS he's an endodontist faculty department of conservative dentistry MDS he is the YouTube infamy on aspire 32. if you go to aspire32 this guy is crushing it i love his videos and I’m so honored that he wanted to come on the show Ellie has oh my god he's got 11 000 subscribers on his YouTube channel he is the bomb in India unbelievable he's currently working in vk institute of dental sciences kla university India as a faculty in department of conservative dentistry and endodontics since 2012 he has cleared many exams in India along with the mbde and adat in USA he is the co-author of many top selling books for Indian postgraduate entrance examinations he is a national speaker and then resource person for keynote sessions and workshops on endodontics he is also the key opinion leader for Orascom healthcare he is a well sought motivational speaker and career counselor for dental students he is a blogger and youtuber with a channel by the name aspire32 with the aim to help learn dentistry better and has a wide base of viewers all around the world under graduation of dental sciences he has demonstrated working in higher education industry skilled in public speaking restorative dentistry endodontics and medicine strong educational professors he covers subjects like dental materials operative dentistry endodontics and many others by sharing his own experience and will not only help you to understand the subject but also write descriptive answers solve the mcqs answer in viva with much confidence when he makes videos he thinks like dental students which will help you make dentistry less overwhelming and more interesting and i just can't say enough about everything he's doing um thank you for coming on the show and where does the name aspire 32 i assume it's 32 teeth you're talking about but where's the spire part come from uh it was about motivating and giving a dream you know if some students have a lot of dreams you know moving abroad or getting a postgraduate seat in India and you know that's exactly the word describes you know to something to aim and aspire um so i i wanna this is dentistry uncensored i always like to talk about the hard-hitting issues um um i don't think um dentists understand you know they spend their whole life trying to learn dentistry to do their surgery they spend their whole life in operatory it's all hands-on and then they um eventually a lot of them want to own their own dental office and understanding the business of that but they don't really think about the macro economics i mean we have a globe with eight billion people trapped on a rock nobody's getting off i think i think 12 have stood on the moon no one stood on the bottom of the ocean where no one's getting out of this place alive but they don't i don't think they understand the changes like like american dentists completely never talk about the fact that the only reason they make so much money is because when the state board license a dentist they also use their police force to not let any non-dentist practice and some of it's out crazy like um like i i practice across the street from the guadalupe Indian reservation where nobody can afford dentistry and there's not one us dentist but every time a qualified dentist from Mexico comes up and practices in uh in that reservation they literally arrest them and deport them and get them out of there because they're they're in their mindset the union's mindset is that no dentistry is better than somebody trained in another country i mean it's just completely insane and it even goes um and even crosses um religious divides where um um there's a religious community called uh Amish and Mennonites and they're not into technology and they're not into um mixing with other cultures and religions that much and every time and when one of their own decided to do the dentistry and just extracting teeth indeed they the the the forces came after him and i've noticed in India um like the united states they've added a lot of dental schools and that completely changes the the economics i remember lecturing in um Cambodia and Malaysia and Malaysia had gone from one dental school to 11 dental schools in one decade and my gosh that changed the framework when i lecture in India and by the way um I’m in phoenix so it's 10 o'clock in the morning so he's in India where it's 10 o'clock at night it's exactly on the other side of the planet and um and I’m so glad i talked to usually when i lecture in India i got to fly five hours to new York and then 15 hours new Delhi and it's so nice to be able to lecture in India without having to uh leave my home but I’ve I’ve noticed an explosion of private dental schools in India um is that what what is your take on that have you seen that i completely agree with you because currently there are more than 300 dental schools in India and uh the situation uh which is worrisome is most of the dentists are you know they are situated in the urban areas and the ruler areas the dentists are really less and that's what is what which is what is causing the you know problem in the Indian scenario for even the dentist and specially it is the young dentists who are coming out they have tremendous amount of stress and a struggle to do which is a part of you know any profession but i do feel that you know when i appeared for the usmbd exam the theoretical aspect what you learn here in India is really good and that's what i try to convey and explain in my videos on my YouTube channel but i completely agree with the fact that the number of dentists who are you know but we have a huge population in India it's the second largest you know population in the world but it is not more of you know it's not about the number of dentists more about you know the awareness regarding the dental health in developing countries as more and more awareness develops here then you know we do have a good scope to practice dentistry in India too so um you just said India is now the largest population in the world second second largest oh second wow um so do you have any hard numbers like how many dental schools were there you know 10 20 30 years ago in India versus the 300 you say um today I’m really not sure but right now i know it's more than 300 maybe 330 somewhere uh if this enormous number of increase in the number of dental college which has happened in last maybe seven to ten years which which is not which is not good but uh you know since we have a lot of population here i hope to see that you know more awareness will lead to more opportunities to the students do you know how many dentists are in are licensed to practice in India i do feel that every year there are you know around three thousand to five thousand dentists you know who clear from the bds degree and for every eight 000 seats there are around 300 postgraduate seats which are available so that number is bit less and most of them start their practice and that's why it sometimes becomes really difficult but the idea of group practice which i have seen in foreign countries is also coming up in India and i hope that you know that helps the students to establish in dentistry so so India has over 300 dental schools with a population of a billion 380 million people and they graduate 3 000 to 5 000 new graduates a year yeah um but you don't know how many um dentists are actually practicing right now in India no i have not checked it but yeah the number is quite big yeah and you know i'll never forget having um breakfast or lunch with the um the president of the Chinese dental association when i was lunch here in Shenzhen and i said um how many dentists are in India and he started laughing he says um he says china is so big and he says that the rule is so enormous he says we would never have any idea and he says our population when he said he said he told me that when china and India state their population if you look at the plus or minus ratio of the accuracy they both fall under the same plus or minus so he says he says there's no way to know if china or India is the most populous and he says he has no way to know um how many are people but he did say that there was an extreme difference between dentistry in the urban where everybody goes to traditional schools versus dentistry in the rural um where a lot of people are still just this like this Amish dentist in Pennsylvania he just decided to do dentistry he had no formal training and he said um he said that the um the rural dentist oftentimes went to a two-year private school whereas in big cities in china all the programs are five or six years long is that what you see in dental school where the traditional universities that date back to the British are are much longer programs than the new private school programs do you see that no uh the syllabus what we have what we get to learn it is quite same in both the dental schools whether you know there are two types of dental schools in India few schools are governed by the government and there are some schools which are either private and some of them are deemed universities but most of them teach the same syllabus for every student and the aim here in India is they should get more number of patients so that they learn better and simultaneously we do concentrate a lot of theoretical knowledge which does help the students so i don't uh i i do feel that the education is really great in our dental schools but as you said because of the number of the dentists who are passing out that problem is definitely faced by most of the students nowadays and how um long is the program um for the average dental school from uh how old are you and all that stuff okay so it it's basically the bds which is an undergraduate degree that's it's for five years in which you have four years of classes and then you have another one year of internship and then after that if you want to do post graduation there is an entrance exam and you will have to appear for it to get a seat and based on the merit you will able to get a post graduate seat that goes for another three years so it is eight years if you want to complete undergraduation plus or post graduation wow interesting so when the kids come out of school um did their families pay for the child to go to dental school or did the government pay was it student loans what who makes the investment when they graduate with a bds it's it's basically you know it depends on the type of seat what you get for example the fees in the government school is really less compared to what you'll be paying in the private colleges and many colleges like specially the government schools also give you some amount of stipend for each student so uh if if some students want to do dentistry and if they cannot afford they can all you know sometimes it's their family which supports them and many students do take some loan and do the dentistry and when they and how much would it cost if a child didn't come from money and he didn't get government help um how much money would he graduate in debt uh it is not as big as what we see in united states because you know when i cleared my nbd and i calculated the fees in dentistry for dentist in united states it's it's really huge but in India you know you will be spending around per year it will be around 3 lakh rupees so 1 000 is somewhere around 75 000 Indian rupees so you will have to spend around 3 lakh per year in India if you are going for a private seat however if you get seat in a government school it may be as low as 20 to 30 000 rupees per year so somewhere uh if you are coming out from a government school it may be around 1 to 1.3 lakh rupees and for a private school it may be around four to six lakh rupees and there are deemed universities also which we charge you more so that will definitely you know end up uh you know charging you more but still this is not compared with the amount of fees what is paid in dental schools in united states wow and do you think the um do you think the Indian dental association will try to curtail the growth of dental schools in the supply and demand equation or do you think um they would stay out of that completely now the the main authority which can govern it is the dental council of India here and of course you know the Indian dental association has been actively you know getting this information in front of the dental council and there are many associations which have definitely you know conveyed this concern to the dental council of India but uh you know it's it's difficult to say but recently in last two three years the dental council of India has tried and they have stopped giving permissions for new dental schools because of the number of dentists which are coming out every year in India the ratio is really small compared to the population the ratio of the dentist is really small but everybody wants to settle down in urban area and that is what is causing the problem it is not actually the number of dentists the another issue being is that the government here has very less jobs in the public health sector for the dentist whereas you know everybody wants to set up a private practice i did hear one of your webinar and you are mentioning that there is a lot of competition even in some places for dentists in united states you know similarly here also we have such type of competition and that's a cause of concern wow these are really complex issues aren't they i agree with you 100 percent um it's tough because on the one hand um um you know you want to you want to keep one eye on the patient but you got to keep one eye on cost and when you're asking a human to donate their individual person the time it takes to become a dentist to pay for that to start a dental clinic um they have to get a return on investment and if it doesn't add up they're not going to do it and it's kind of funny how i know uh a lot of people in their countries that are free enterprise democracy they always think they live in a democracy with free enterprise and what they don't realize is that all the evidence shows that all democracies are very micromanaged on the supply and demand i mean the laws they set up the regulations they set up um it's it's kind of like when people um say karl marx um who was a great economist when they um i i mean and the the the only thing i love about marx is yeah yeah he had this thought and no one has any real faith in it and he didn't have any faith in it when he was older 40 years after he published it but what i like the most about marxo is the fact that um a lot of the um economic history in a very in like a 20-year period he was the only guy writing it he was so passionate about economics i mean there's so many economic um data points where the only place you're gonna find them is from marx but um karl marx uh fell out of love with his idea but it was never tried out and i'll tell you another thing that was never tried out was free enterprise capitalism laws fair where people just traded uh amongst each other for the goods and services they want um well let me just put it uh more simple like this like when i look at um purchasing power parity on currency markets i I’m I’m small-minded i like like the big macs index you know how much does a big mac cost in every country i can i can figure that out um tell me this is being a dentist um a great job i mean does it is it if you're if you have a bds degree in India by the time you're 40 are you usually in the top five percent of the income uh amongst the uh billion three hundred million people dr howard it's really complex in India you know the most important thing in India is the patient doctor relationship and most of the time it is based on trust and the publicity happens based on the mouth to mouth in India because you know the worst has to pass that this doctor is really good so these students you know or the dentists who are really skilled really hard working end up succeeding a lot so it is not that the dentistry doesn't have future in India that is wrong to say because i it is ultimately it is not regarding the degree what you have either you are a post graduate or an undergraduate it depends on many factors and i have my colleagues my seniors who have practiced very well quite busy don't have time you know and the patients are so satisfied and they have so much trust on them they have succeeded a lot but of course there is competition in India at every field you know my brother is a tran transplant surgeon you know he's a liver and you know multi-organ transplant surgeon even he says it is important that you have to do a post graduation even though your success may not be dependent so if you decide the success based on just the degree then it may not always match because there are students there are dentists with just bds may end up earning more may end up earning less but ultimately if you have good skill and if you have good trust no patience trust you there are people dentists who are earning a lot but currently in today's generation compared to few years back the dentist especially in metro's areas tend to earn more because the paying capacity of the patients has also increased drastically in India compared to what is to it used to be there many years back so it depends on multiple factors whether you are practicing in metro areas whether you are practicing in a smaller area and that decides whether how much you are earning so it is difficult to say it ultimately depends on the individual and how much he is interested in joining the dentistry yes um you said that so well i mean it still always comes down to word of mouth referral it comes from trust and it's hard in dentistry because we sell the invisible i mean when i sell you a bottled water or a can of coca-cola or an iphone you know exactly what they are so you can shop it on price but when i tell you you have four cavities you know you i mean i i just have to believe you or not believe you i mean how would i know if i had four cavities like um I’m 58 so i had to start getting uh the the colon cancer screenings um when i was 50 and you know he tells me all this stuff and I’m like well what's the bottom line and he's like well i gotta see every five years for the rest of your life i mean i just trust him i i don't I’m not gonna look at any any thing up there i mean i i don't know what I’m looking at um when um what you have done on YouTube is just dentally miraculous i mean you got eleven 000 subscribers and i my gosh i how many videos do you have i mean um i have around i think 70 videos till now 70 videos yes and so when they come out of school um and i don't want you to have to talk bad about dental school education so i'll just say it here i mean when when they come out of dental school especially now during the pandemic many of the kids that just graduated in 2020 never did a root canal on a live human it was only on extracted teeth this has been very challenging they've learned all the didactics but as far as practicing hands-on surgery this has really changed but when they come out of dental school in India um where do you feel um they're the least trained and where you can correct and and bring them up to speed fast what subjects is it is it root canals is it extractions is it implants where where do you see the students um wanting to learn more after graduation so overall i think uh the dentist in India is highly concentrated you know when it comes to treatment it is more of endodontics and conservative dentistry and of course I’m not sure whether you agree with it but most common uh problem with or the complaint of any patient is the decay and the pain and that is what everybody wants to learn but i do believe that it is really difficult to learn dentistry you know just because you have not learned a lot in korea and you will come out and you can learn dentistry and cover this lag what you have in during the covid that's difficult to you know say because it takes many years and I’m sure you would agree with this because the dentistry is always uh you know you have to learn there are new things every day and but overall i think students uh would like to learn more of a cons and endo that is restorative and endodontics which is really difficult because it is more of a clinical practice but as they have more time they would also like to concentrate on dentures extractions but in India it's it's probably only one single batch which is affected in dentistry here and i hope that the next batch which is which maybe if the kovid ends in another two three months and we get the vaccination they may not face this problem that they have not done sufficient amount of patience interesting interesting um so you you're saying that um in India the the two main drivers um to drive a patient to calling and going to a dental office are decay and pain yes yeah and and is there uh when you say um decay and pain are they mostly getting extractions and endodontics or is it um no the major see as uh nowadays i in the olympic countries too the awareness is very high and everybody wants to save the tea so unless it is really meant for extraction they would not you know be willing for extraction so most of the treatment here are more about the root canal treatment and in last two three years or you know the implants has also picked up but at the undergraduate level it is more of you know the root canal treatments and the extraction and the restoration and that is what the patients you know most of the time complain of and visit to the dentist and i notice when um i notice you really never say um restorative dentistry without saying putting the adjective conservative restorative dentistry you you you love the word conservative um where where does that come from um it's a strong word for you in India we had the we have many subjects like the subjects are divided orthodontics prosthodontics similar to what you have in united states or any part of the world but it was earlier operative dentistry and then the name is now termed as conservative dentistry because we are more focused on conservation of course you know and i do believe you know as an endodontist see in India for a post graduation we have conservative dentistry and endurance together but in foreign countries you have either restorative dentistry or endodontics so that's why we tend to speak more about conservative dentistry because that's really most important when you plan when you do a treatment plan you know we try to be a conservative dentist first before you know jumping on to the root canal treatment and that's why you tend to hear you know i tend to repeat the word conservative a lot are they more interested in learning how to do like direct composites or more endodontics or more extractions or more orthodontics uh what what are the main on your YouTube channel i mean anyone who has 11 000 subscribers on their YouTube channel is the epitome of understanding the demand um what are what kind of knowledge are they demanding the most what would you say the top three are if you were at mcdonald's and got a fish sandwich of frying a coke what would be the fish sandwich frying a coke well i i make videos on conservative dentistry and endodontics more because most of the time the exams either in Indian entrance exam or foreign entrance exams which based on my experience when i appeared i found that the questions are mostly related to these branches they tend to ask you more about restorative dentistry and they tend to ask you about endodontics and the nbd part two you know probably the inbd which is the latest exam in united states it's also mostly concentrating on the clinical based questions so the issue with these exams is that the students really find it difficult especially the international students who have done limited number of patients you know and and that is what they find it difficult to clinically correlate when the questions appear in these type of exams and that's why i concentrate more on conservative dentistry dental materials because they are difficult to grasp but as a student it ultimately comes to you know their passion and their uh you know the interest in learning because if you ask me i was always interested in learning conservative dentistry and endodontics than any other branch so it is difficult to pinpoint that what student would like to learn the idea the the thing what we follow in dental school in India that they have the postings in each department and some postings are there for one month and two months and they would learn that treatment plan during those days and someone who is more interested in learning conservative dentistry he will definitely will be doing more number of patients when they are in that clinical posting so i notice um all democracies and countries have a problem where the dentists all end up in the urban cities i mean even the major dsos um the the commercial chain dental operations that have you know 500 or more offices they won't even go into rural america and I’m reading on India uh the distribution of dentists in Indian states it is estimated that 85 percent of indians who reside in rural areas are served by 15 percent of all the country's dentists so um how do you think um dentistry has to try to get more dentists to go into more rural areas as opposed to living in the big cities i mean i get it they come out of school they're young they want to find a mate for life and who wants to go look for your one soul mate in the world in a town of 1000 if you could go to new Delhi which has 38 000 38 million people i mean how can you drive young kids to want to go live in rural areas yeah i would not completely agree with the fact that the dentists uh are not going to rural areas now i myself visit my friend's clinic in a rural place once in a month and render the services there so if you see the amount of dentists who are visiting the rural areas now it's quite increased in India they may be residing you know they may be having a clinic in this city in the urban areas but most of them do visit and provide the service in such type of clinics in the rural areas so I’m quite happy that you know and i believe that there is a tremendous amount of joy and happiness in providing the service to such kind of people who really cannot afford it a lot or do not have a reach you know don't want to come to the urban places but the rural population also nowadays can afford good type of dental treatment in India and that is the beauty you know that which i do i find it difficult in some developing countries because when i talk about the foreign countries it is mostly driven by the dental insurance and with my limited knowledge which which have learned over a period of years that someone who doesn't have an insurance they find it really difficult to get dental treatment in foreign countries but India it is within the reach of the population and even rural places we are providing treatment for most of the population with a limited amount of charges um I’m sorry to ask such a stupid question but even though I’ve lectured in Delhi how come some people call it new Delhi and others call it Delhi is it the same thing or does it mean something different when someone says I’m in Delhi versus new York okay now i think it is more about the old Delhi which was an initial area and then it has expanded and now maybe everybody calls it as new Delhi but if you see when you go to Delhi that of course you have uh old traditional Delhi there and then a developed part this is what is my understanding but I’m really not sure about it we do call it as you know Delhi or new Delhi it's quite interchangeable um i um have to tell you that when i um lectured in India for the first time this is why you know um i i think the most important thing to develop your mind is to travel around the world um i took my four boys I’ve lectured in 50 countries and i always took between one and four of my boys with me and now um they have six made six grandchildren and they still look back and say they learned more from traveling than they did from reading books in the university and i um when i grew up in kansas i mean my mindset of India was this vegan hindu country that just ate clean and you know just the best eaters in the world and then when i went and lectured over there every dentist house i went to i was offered plates of sugar cookies and and my gosh they they eat as much sugar as anybody in the world i don't know do you agree that they eat a lot of sugar absolutely that is actually a big part of the food in India and the diet and you know mostly after the food we all would like to have sweets there and it's we are proud of it we have so many dishes in India and I’m really not sure which all you have tried but of course sugar is not good for health and people are aware and they are more concerned but still many the majority of population you know they do like sweets a lot which which is difficult to you know remove from the diet yeah so then does that have a um big effect a big effect on the decay i mean is yeah when you look at trying to lower the disease missing infill tooth ratio of India um is is diet going to have to be a big part of that equation it will also depend on which type of you know the food multiple factors because the sweets what we generally eat is restricted during the meal time right and of course the culture of junk food has also you know evolved in India and maybe that is a major contribution for the incidence of keres but simultaneously the awareness regarding the oral hygiene is also increased but as you know everybody would agree that if you have more frequency in you know taking more sugars very frequently then it is bound to have you know more increase of decay but the diet also there is a vast difference what you have in the south India and the north India so sugar may not be the only criteria to decide whether you know the Indian population will end up having more dental decay yeah i um if you haven't been to India you just gotta go it's just so cool and um but it seems like most of the people in India um live right up against um the the eastern border of um my gosh uh kashmir bangladesh um you know the eastern side um as opposed to the the other side um so and then and then the south so you're in the in the real southern tamil nadu region I’m uh very near to that uh state beside that that is karnataka uh which is south part of the India and um and and then um and then the rest is really kind of up north it's really uh it's kind of like europe it's several countries of um living and one people even the language the dialect it really is uh no no different than europe i mean you can't compare uh new Delhi uh to karna karnataka would you agree that it's um different languages dialects names yes i myself speak many languages english is not my primary language i studied in a school small school a government school which was which taught us language as a primary language and then simultaneously we learned the hindi which is a very important language in India and then my mother tongue is konkni so i have three languages here but apart from that in the place where i stay we have another language called as marathi which we learned during our childhood day so i know english hindi marathi kannada and my wife knows another language which is punjabi so we have so many languages in India but it is it is everybody has their own speciality and majority of them you know they do speak most of it so that was uh the lead up to my uh other question so i noticed all of your videos are in english yes so um can all the dentists uh speak and hear and learn in english as easily as their native tongue i mean is it kind of absolutely yes yes there is because you know it was during my time that we did not go to a english medium school but my own son studies in english medium and they are more exposed to the world they have so much of uh you know they learn so many things from the childhood so i don't think english has been a very big problem now and we learn the dentistry the official language is english here and everybody nowadays at least those who are in education have learned english very well but we do have that Indian accent which you know sometimes become difficult for the foreigners to grasp well they they americans are suckers for an accent i mean uh they uh if you have a British accent or an australian accent i mean they just even the two biggest uh take uh talk over uh voices in america who's the guy who did roots um darth vader who jamesville jones james earl jones and then and then milton um morgan friedman they're saying from the same county in the lower delta river of mississippi and it's a really rare accent and so they're the biggest talk over host in america because everybody loves an accent i love uh listening uh to operators who have that new Delhi hindi accent and i think it's adorable so um when you are looking at techniques you know we have the problem here where like say endodontics you're an endodontist so I’m going to focus on endo um you know i always tell people when they want to tell me their idea i always hold up my hand and i say there's five fingers on there is it better is it faster is it cheaper is it higher quality is it smaller is it you know and and and if you can say yes to faster better easier higher quality cheaper you got a home run but it seems like in dentistry um they don't get it like they just came out with that a sawn endo device and i mean the machine is like 70 80 000 not and just after even if you got a machine for free each case you're gonna have to spend 50 60 70 or more on each case and then it's it's a it's a great piece of technology for cleaning but when i talk to my homies the hardest part of a root canal is finding all the canals and and working it up to a 20 and these sawn endo cleaners they don't that that's when they begin um they're not helping me find an mb2 they're not helping me enlarging it enough um from a six file eight file to a 20 um so um it's kind of an expensive luxury add-on in a country called america where half the people cannot afford to go to the dentist do you see that problem in India in endodontics where a lot of the new technology is just they've priced themselves out of the market absolutely i would agree with it because you know i have been practicing endodontics from 2012 and i have seen how the materials and methodology have been changed over a period of time and all these new techniques and new equipments which is introduced of course you know when you consider the market in India you know they may be concentrating these expensive equipments they mostly concentrate on these countries like where people can afford it but India also few years back you know when you think about the rotary instruments they were introduced in India after two three years but nowadays as soon as it is launched in foreign countries in the same time it is also available in India but when you talk about the affordability and i truly believe you know i believe that the treatment should be within the reach of the patient it cannot be too expensive for the patient that they cannot afford it because ultimately we have to make sure the oral health of the society is benefited from the doctors if you make things very expensive it may be difficult but i won't complain regarding their invention too because you know it is there will be always new things which are required in the market but if they are very expensive it ultimately leads to the or you know it is the decision of the operator or the dentist whether he should purchase it or not but trust me dr howard if you if i would as you said and i have seen your webinars where you were talking about the microscope and i i do feel that you know that increases the time of the practice but the quality may increase but the principles in endodontics have not changed drastically it is basically the organisms and the type of disinfection what you are carrying out and maybe you can do it with less you know sufficient amount of affordable equipment what you already have so those that can also give you a good quality treatment because the organism load is what we should concentrate so how does an online platform like aspire32 on YouTube how can you teach a root canal through YouTube without hands on i mean um is it do you think that's uh really not as difficult as it sounds um i notice you know people watch television shows all day long about cooking and they watch chefs and america's got some crazy big shows like cupcake wars like people are you know putting their whole life trying to make a better cupcake than you are it's just it's it's so ridiculous it's funny and you have to watch but do you um do you think um the future with online low-cost platforms like YouTube that your aspire 32 can really aid in teaching a dentist how to do dentistry better faster easier cheaper higher quality without hands on or do you see the future as they'll watch you didactically on YouTube but you'll mail them a box or a kit will they sit down and do something on a typodont while watching you on a YouTube do you think they can do it video only or do you think it needs a hands-on component yeah i i did not start aspire 32 you know to replace the conventional teaching i would like to tell you why i started with aspire 33 when i was there in united states and appearing for my nbde that time i came across a channel called scan academy and I’m sure you have heard about it and what's it called khan academy um spell it k it's ian k-h-a-n academy yes oh is that is that where he teaches math yeah exactly yeah i love biochemistry and what i realized is uh you know you have such a good teacher on the YouTube platform and somehow as a student i believe that the teacher may not always be approachable and when they read the topics from the textbook it is sometimes really difficult you know correlate for example we teach about the all the type of restoration in the second year of the dental school here but you know we concentrate practically on only one or two restorative treatments so it becomes really difficult to understand from the textbook that what exactly the author is trying to convey and on my channel i try to make it as simple as possible and i do mention the textbooks which they should read so it is more about helping them you know to go back and read the textbooks again and understand it better rather than completely replacing it if you see my aspire 32 channel or you know even if you see khan academy they don't talk about you know the clinical procedure it is more about theoretical i do believe you know that the YouTube has a lot of potential to even help you to understand the clinical uh protocols better because there has so many amazing videos which tell you you know if you if you want to see a pulp capping procedure there is a high you know a magnification a nice picture quality which a student may not be able to learn on his own in his first case or second case but if he sees it online then it can help in help help him learn better but as we all agree dentistry is a skill based branch it can be only learned by doing more and more clinical work the online platform is just an adjoint you know which can support you to learn it better and what what have you um taken away from the khan academy that you think um that i mean i i think that has to be everyone's role model in the online education platform what have you uh learned from the khan academy that you try to do with aspire 32 what i learned from khan academy is he is really passionate about teaching and someone who is passionate about teaching can be really benefited with the online platform and there are students who may not understand the topic may not have a maybe a teacher who can convey the message to the student in a very easy way but the khan academy does it in an excellent format and he doesn't have a lot of equipment he just have a black screen and a digital pen which can help you to learn take the example of biochemistry video what he has posted and if you see the videos on krebs cycle we tend to mug it often but there he has explained it in a very nice way you know helping you to understand which step is very important with you know and how it is connected to the other biochemistry cycle and the same way on aspire 32 i try to teach them and i try to tell them what is important to and i i give them an idea why this point is important to you know to understand rather than simply you know mugging things and it is not just the khan academy khan academy is a very big platform but the beauty of the online platform like YouTube that anybody who can teach better can succeed you know can get a work satisfaction in teaching on online platform huh yeah the um that saul khan is just an amazing man i mean what what an amazing man he's doing that and i think he started because it was uh wasn't it for like his sister or daughter or aunt he had a hated niece or a nephew he was trying to help long distance so you actually had to figure that out just to help the family yes yeah what what an amazing man so on your um on your videos um my gosh so um okay let's just talk about the last one you have um what is a sandwich technique and um i watched the video it's just amazing everyone loves it it says in this video i will be discussing sandwich technique in detail easy dentistry at aspire 32 helps grasp such topics of dentistry in the simplest possible way for dental students and dentists the video of aspire 32 is made by dr yours truly suresh shinvy who has cleared various amounts exams like adat nbde from the usa dha from dubai and various Indian entrance exams like pgi kcet and eet um i am mds in conservative dentistry and endodontist by profession I’m also the author of dental books on the entrance exam and i am also currently a faculty at kle university and receiver of best teacher awards wow uh your university must be very very lucky to have you um do you see your uh videos uh helping you hand in hand with your teaching at school or um you know is that do they go hand in hand together or is it um how does that work yeah whenever uh when I’m making videos for the students earlier i used to concentrate on the topics which my dental school students would like to listen to but when i started my channel and got feedback and comments from the viewers across the world you know i tend to concentrate more on the difficult topics which most of them you know do comment and they request that i should be making a video on such topics so i take such topics there and in turn it is going to benefit the students of my dental school and of course whoever is appearing for exam at any part of the world or any students maybe in the middle east or any other country who finds it beneficial and do you find um what i always love to um when i travel around um you know it's it's one species they have the same brain they have the same microbiological disease of these bugs eating sugar and getting um help from fungi to block the immune response etc but i always like the way they slightly do everything different i don't care if it's making a restroom a shower a window cooking food what variances do you see in dentistry i mean i know you have a lot of students from dubai um united states um um I’ve noticed things like um glass ionomer is um way more used in japan australia new zealand than the united states of america you were talking about this sandwich technique to me that's one of the clearest examples of how dentistry treats problems differently depending on the origin of where they were born and trained do you see much variance in how dentistry is approached as you go to the seven different continents absolutely a few years back maybe seven eight years back people used to do lot of dental amalgam restorations in India and nowadays we are more in composites and of course glass eye number has been there whether you are doing an amalgam restoration or if you are doing a composite restoration but it is we have we don't tend to use it more as a permanent restoration it is mostly used as a base or as i said a sandwich technique but we are shifting more towards the composite restoration in India and indirect restoration because we have better dental labs in India now who give an excellent quality restorative materials and the latest technology but i do agree that other countries maybe the treatment plan is different but it is hard to say you know because i have not seen the treatment plan of all the countries but the students who go to ex you know who appear for the nbd exam in the united states especially the students from other countries do face this problem because i remember the second day of the us exam that is the nbd part two the treatment plan in united states is completely different than what we tend to follow in India it is more about implants you know but we tend to try to be more conservative here and less of implants but yes now the implants is picking up in India it is changing it's a dynamic environment but we are trying to facing you know phasing out dental amalgam in coming years and um I’m uh gosh i realize i i don't know why i scheduled you on 11 24. why did i schedule on november 24 when if i were to schedule you on november 14th we could have done this on happy diwali day uh my gosh i i was not thinking uh the festival of lights uh the the victory of light over darkness good over evil knowledge over ignorance and hope over despair deep means light and volley means a row so did you have a happy uh diwali day absolutely it's a very big festival festival for all of us and uh it is one of the big one i did visit my brother who stays in the Bangalore another place of Karnataka with you know all my kids with my niece everyone had a great time and yes it was really good especially considering this covet scenario where we had a lockdown in our country and we used to hardly meet people and it is just now maybe one month we are even you know meeting people and traveling just started traveling that too limited and we really enjoyed this Diwali in India because of the current situation oh my gosh well you know i I’m so glad uh i brought that up because um I’m um I’m sure everyone's uh dying to hear um a report from you uh on the ground in India on kovid and uh what does the situation look like is it um compared to um other diseases or in your whole life how old are you I’m 35 35 so you've lived a third of a century a third of the way back towards the last uh um spanish influenza which actually started where i was born in kansas um the the the world thinks it was transferred from a pig to a farmer and then he got drafted for world war one and went to leavenworth where they had the first major outbreak in america and then of course as they shift those troops around uh you know the infection rates follow and i know that my epidemiologist who uh taught me um in grad school um surely thinks that it started in kansas from a pig but um is it how would you describe the corona i mean is is it really bad is it just more media than hype how how would you describe it how does it look right now right now we are still following the guidelines which is given by the government here we are wearing masks we tend to attend more of emergency cases in dental treatment and the situation is definitely improved because the number of cases has decreased drastically but it depends on which state you are staying for example in my state the numbers are less and if you see the new Delhi the cases are there is supposed to be a third wave in new Delhi and few other states in India but the good thing is people are more aware about the situation and people are taking precautions but we are hopeful that the vaccine would come up and there are definitely some good news we have three waxes two of two of vaccines are from the united states and one is from oxford and which oxford one is getting manufactured in India and i hope that at least the health care professionals get the vaccines early it is difficult to say because few of my colleagues got the kovid and most most of them were asymptomatic but i did have few of my relatives whose you know someone who had medical conditions or over than 60 years some of them have lost their life so i we do consider at least my family and all of us my friends we can consider that yes there is chance of serious you know consequences of kovid but the the issue is really controversial because some countries have not believed on lockdown and India went through the lockdown but i believe in my country and I’m sure that they have taken the decision in best interest of the the their uh population here and the citizens so you've lot you know people who have died from it then yes wow I’m so sorry has that um been really hard on you yeah because when we read the reports in the newspaper most of them say that you know it may be as not as life-threatening but when it happens in your surrounding that is when you start feeling it so i do believe that until the vaccine comes there is it's not wrong to take precaution it doesn't take a lot of effort to wear a mask so if it is going to benefit then why not do it and the statistics i do believe in statistics throughout the world in united states when i read there is good num you know quite number of deaths which has been reported even in India we had such numbers but it has reduced that is a good news what do you believe dr howard i wanted to know your opinion regarding um you know um fear is something that all dentists understand because people have fear of the dentistry and and it doesn't make sense all the time because like most people are afraid of getting a shot um but they'll have a bar through their tongue or they'll have you know metal clips to their eyebrows or their whole arm is sleeve with a tattoo where they've had a million shots um but it's kind of one of those things where you know the united states um has the same population as India minus the first numeral digit of 1 billion if you just take away the 1 billion the remainder 380 million united states got 330 million and there's about a thousand people dying a day and half the country thinks why are we doing all of this crazy economic hardships for a thousand people a day and i can understand that feeling but look at airplane flying um in the united states last year only one person died in a commercial airplane and 36 000 died in a car so when you look at it and everybody's afraid of flying and i don't know of anybody's afraid of driving so it's very irrational but back to that 1000 deaths per day well in america if two fully loaded boeing 747 airbus jumbo jets fell out of the sky 500 people each and a thousand people died every day i guarantee you america would close down every airport within an hour i mean they just wouldn't even debate it but since it's individual on the ground driving their car they just know it's not going to happen to them so when they can see the death like two airplanes i mean just imagine two 747s flying into each other and crashing over uh new Delhi falling to the ground everyone died oh this wouldn't even be a debate but since they really don't see it and then there's another really bizarre thing is that is think of two worlds say India and the united states each had 100 people and they each had 100 people in the united states only 10 people caught coronavirus and one person died so what would the mortality rate be it'd be 10 of those people that got infected and then let's say in India you had 100 people but they all got infected and you still only had one die well in the united states you'd say oh my god 10 people got it and one died that's a 10 mortality rate I’m scared but in India if everybody got it only one died that's what they say they say well you know it only kills one percent of the people well yeah it's one percent of the people but it's not one percent of the people who catch the damn virus and then there's that age like I’m old I’m 58 years old i got six grandkids and I’m male and I’m bald um these are all um they know that the coronavirus enters the uh ace uh the uh android receptor but um i figure from the people I’m talking to in my backyard that if i actually get the virus it's a five percent chance I’m dead and another five percent chance I’ve got long-term uh injury so i think um when the vaccine comes out there's a big threat on dental town are you going to take it are you going to take it i mean I’ve already isolated myself from march to november so march april may june july august september october november so I’ve already been living like this for nine months so I’m not gonna run out and be the first guy to try the vaccine but i will sit back but um as soon as they've got you know um you know as soon as older people in phoenix are getting the vaccine and the risk versus reward i mean I’m going to compare the risk to if i get this thing on the street five percent death 5 long-term um health issues i want to see what I’m comparing that against if the vaccine i don't think the vaccine's going to have a one percent death i mean i i don't think that at all uh so i i think i i'll be very um excited uh about this and it would be amazing to get life back to normal but again um you just saw I’m sure you are aware of the united states just had a presidential election and my whole life there's always been and it's not more divided than ever before i mean people say that i mean just open up a history book we had a civil war a hundred years ago I’m pretty sure that was a more divided time than now when they actually killed one out of 30 americans during that division they're not doing that now um but um half of the united states including all four of my four boys because they're all young under 30. they think it's ridiculous they don't care it's like the flu you know it's something that grandpa worries about and it's embarrassing i mean when your own children come to the door and the grandkids say well can we are we gonna go in and see grandpa ah grandpa's afraid of catching the flow he's in there hiding and I’m like oh my god so I’m just so I’m just so waiting for this damn thing to be over but again what I’m mostly glad about is um that it's a global world war against another species a virus i just i'll take that any day over the week as opposed to a war against other humans on the same team sapien i just hate it when sapiens fight me we gotta fight against blowing up neutron stars we don't even know why we've had six mass extinction level events we got viruses tuberculosis cancer the last thing humans need to do is be fighting with each other i mean if if they're fighting with each other they must be completely unaware of all the other problems that we have to solve and and and i want all 8 billion humans on team earth fighting these uh things like viruses um so it's uh so there's good news and everything and I’m so glad the bad boy was just virus i know we're over a time we've gone over an hour i know it's uh coming up on midnight there um but i can i ask you a couple more overtime questions yes definitely um orthodontics um i you know it's basically every species wants to find and consume enough resources to live long enough to reproduce and have offspring so they all want to look as pretty as a peacock for the same reasons the young dentist won't go to the rural areas they want to look like a pretty peacock in the biggest city to catch their mate and orthodontics is um it's just a big part of that facial smile is it a um is it you know growing faster than any other segment of dentistry in India is it growing faster than you said pain and needing a root canal was the main driver do you see orthodontics and the desire to be as pretty as a peacock um growing as fast as endodontics do you think it'll ever overtake endo in Delhi the orthodontics have been always a very popular branch in India but i do believe that you know people are more concerned about their aesthetics and the aesthetics not is not only restricted to the orthodontics and we all know that cosmetic dentistry is a very a big part of such treatment plan if you talk about the aesthetic dentistry then i would truly believe that it is really catching up with the overall treatment and the patient's desire for visiting the dentist especially in the metro and ortho yes but it is less about the aesthetics it is more about whether by taking orthodontic treatment it is going to benefit them to maintain a oral hygiene unless uh the appearance is drastically affected by because of male occlusion people will not seek orthodontic treatment and it is sometimes the duty of the dentist to explain that the patient may require authority treatment and make them aware of this issue what they have with the tooth arrangement and then they would definitely go ahead with it but if you have a minor male occlusion okay which may not affect the aesthetics in a drastic way they may not always go for it but if you talk about aesthetics for example if somebody wants to enhance this smile then of course they would visit the dentist so it is mostly related to the patient self-motivation whether how important is the aesthetics for them interesting and do you um I’ve noticed um I’ve noticed in many countries um take um philippines and Cambodia a lot of southeast asia you see most cosmetic dentistry is by the women and not the men i cannot tell you how many women i met in southeast asia where the woman's front upper 16th upper and lower were all beautiful crowns and her husband had no teeth or um you know i i just always saw even with dentists like the dentist would have crowded teeth kind of brown and dark but his wife had you know all the cosmetic dentistry is it still a male female thing are women in India buying more cosmetic dentistry bleaching bonding veneers and ortho than their male counterparts or is it more equal i do agree to this fact but i am sure that we can agree on a point that you know females are always more concerned about the aesthetics but recently in India too men are aware about the the aesthetics and the number has been increasing and the reason for improving the smile and aesthetics has been definitely a major motivation for them to visit the dentist but of course there is a vast difference and even today the number of female visiting the dental clinic for aesthetic correction is definitely more and i hope that you know the men will also the treatment for the aesthetics for men will also increase in coming years and is that um do you think that's mainly that women get more cosmetic dentistry just because the men are so much naturally more handsome and don't need it no i i read a very beautiful quote which says that beauty lies in the eyes of the beholder oh good answer good answer so if you ask a dentist whether you know if a patient asks a dentist whether my smile is good he will have definitely many reasons you know to find out whether that one tooth is rotated and that is affecting the smile of you but you know it is not how the patient perceives it they would always somebody from there a family member or a relative has to or a friend has to you know to tell them that this is the issue with your smile and they become more concerned than the dentist making them more aware but i i really don't know whether you know that the point what you mentioned may be important reason for the differentiation and last questions um you are uh an instructor um at um kle vk institute of dental science correct yes and that and also the um um education college of dental sciences that that's a separate place right bapuji yes a dental school which uh is in davangere and I’m working in kelly dental weekend of dental sciences kelly university which is in a different place we I’m from a place called as belgium belgavi but they are quite near to each other it's a four to five hours journey but two different places and um or how are they uh last question how are they um doing during the challenges of a pandemic basically we have a set of guidelines which is given by the dental council of India which we have to follow most of them advise that we should be concentrating more on emergency dental care the pp kit should be worn n95 mass the shield and we have the air purifiers the extra oral section suction and the hepa filters these are the important guidelines which you have to follow whether you are in a private practice or whether you are in a dental school if you have this then most of the dental schools are doing limited number of patients but with these proper protocols which are given by the dental council of India wow um just just tough times for these kids uh i just i just feel so sorry for him um but I’m telling you um it was just an honor for you to stay up till midnight to come on the show today and talk to my homies and uh again if you haven't checked out his YouTube channel you're just um you're crazy you got you got to do it um check out his YouTube channel and uh all you got to do is remember aspire32 and uh just aspire to learn more dentistry faster easier uh lower cost i mean it's just uh what you what you're doing um surash is uh just amazing i'll never forget when i was um um i was doing i went to climb uh kilimanjaro and it was in tanzania and um i got to you know for me i don't like to shop i don't like to buy clothes and shoes and all that but my gosh when i see a dental office I’m right in there and i was amazed at how many countries I’ve been in where it's so rural and it's so um you know it's just um it's a developing country but she's got a smartphone she's on android she's on YouTube and she's watched a thousand hours of YouTube and I’m sitting there in her office it's like i would let her do a root canal on me all day long and this just was not available i remember when i started lecturing international like back in 1990 most of those countries if english wasn't their official language they'd have to have a translator no one's no one's uh had to translate me for a decade because even though they might not even speak english they understand it they're all on the internet they're all on the same platform and you got the the international language of the math of science is mathematics and the international language between scientists is officially english since like 1945 and anyone who's a doctor a physician an engineer an epidemiologist they all learn the official language of english and the information is almost at zero cost there's so much information it's almost at zero cost and it is just to me it's blown my mind what that smartphone has done to dentistry around the world which is why i will still always say that 2007 was the year that um humans uh plugged everything they've gotten to a smartphone the internet a calculator a phone a tax to email they put everything into one device in 2007. uh steve jobs pulled that off an apple and i said that was the birth of the greatest century that homo sapiens ever lived through and i think 2007 to 2107 will be our finest century ever despite the pandemic and on those uh notes i can't wait to see you someday in India when you greet me with a big plate of sugar cookies so thank you so much dr howard for inviting me for this podcast it was a great pleasure to hear from you and i have seen many of your videos they are really helpful and i hope that students who visit my aspire 32 channel find it beneficial and as you said it will be a great pleasure to meet you once in a person when you visit to India well you know on dental town when you make a post um we have uh one of the buttons is the YouTube icon and so when you click a YouTube channel um you click share it gives you a little code but if you go next door it's in bad it's the code of the channel and you can drop your video right into a post on dental town and everybody that does it says it's the cheapest fastest free marketing for their YouTube channel um because you're exposing it to a quarter million dentist and they say their subscribers uh jumps up the same thing with podcast i mean you can put your podcast for free on dentaltown 2 and everybody says that explodes their views on itunes so um yes yeah i think and also you can do a search like when you say on your video on the sandwich technique you could do a search for dental town for sandwich and then go to that thread open it up and uh hit reply dropping your YouTube video and they and they'll be able to watch your video but it'll still be you'll still get a view an account and they'll register and subscribe it's the same thing it's a neat thing that YouTube does but i think you should do that um and to show them what you said i visited i visited the website yesterday and I’m going to register by tomorrow it's a very wonderful website and i did see that so many information is available on the site which will be definitely beneficial for me and all the viewers of your channel and my channel and definitely i would register myself as soon as possible and and if um and if you ever think in the dentist in India need their own dental town or anything i can copy and paste that 500 000 lines of code that we've been working on since 1999 and you could run run off with dental town India if you thought um it's different it's whatever the dentist needs is whatever whatever my homies need to be able to um practice dentistry faster easier better higher quality with a big smile and if i i'll do anything for my dentist but uh thank you so much for coming on the show and i hope you have a wonderful night's sleep since it's way past your bedtime thank you thank you so much

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