Prophylaxis First — A New Era or Just a Trend?

Antonello Croce (host) 00:00 Welcome to Next Dental, where we talk about what's changing and what's next. Our guest today is Dr. Khalid Hannouneh, and we're talking about prophylaxis. Something that might sound familiar, but it is not because we will see it from a different point of view.

Antonello Croce (host) 00:18 Good morning! How are you Khalid?

Dr. Khalid Hannouneh 00:19 Good morning! I'm fine. How are you?

Antonello Croce (host) 00:20 Good. Everything

Dr. Khalid Hannouneh 00:21 good to talk to you Antonello.

Antonello Croce (host) 00:23 Good to see you today. Thank you. I would like to ask you, um, why did you choose to build your practice around prophylaxis? Like something that, uh, other clinics might treat as a secondary instead of you open the clinic, uh, now around.

Antonello Croce (host) 00:41 Prevention. So why did you choose, did you make, did choose?

Dr. Khalid Hannouneh 00:45 First of all, thank you for this chance. That's where we actually, um, meet and talk about this. Um, I think if we, if we want to build, if I want to answer, give you a reasonable answer, I have to build it on, on, uh, some, some information before. So, um, as you know, I have built my clinics already, uh, before, uh, on.

Dr. Khalid Hannouneh 01:09 Polyclinic or specialized dental clinics where we have all specialties from cosmetic to orthodontics, orthodontics and uh, oral surgery even in implant. And, um, and we've, we have done in like in Dubai, in the downtown, uh, business Bay and we even did one in SJA, um, SJA as well. Yes. Yes. In SJA. And SJA is more of a big medical center where we have other specialties.

Dr. Khalid Hannouneh 01:34 And we started adding things to this because like lasers and stuff, uh. There was a major, let's say, uh, transformation point. Now my background, when I came here, before I started even getting my license and, uh, working in the clinic, I started working with companies, dental companies Yeah. For, uh, marketing and sales of dental materials.

Dr. Khalid Hannouneh 01:56 Yeah. And, uh, during this period, I, I had an interaction with different. Companies, different types of technologies. So I was training for the Painless Dentistry, uh, STA or nitrous oxide. And, and I was involved in something called Painless Dentistry. So I, I read more about Painless Dentistry and I found out painless.

Dr. Khalid Hannouneh 02:15 Painless, not pain free. Yeah. Remember there is two concepts. If you wanna talk science, we cannot say pain-free because when we say pain-free, we are giving a promise of a hundred percent. And as you know. As scientists, we cannot say a hundred percent. There is no such thing as a hundred percent. So we always give a, keep a small chance.

Dr. Khalid Hannouneh 02:32 So painless dentistry was revolving around, uh, providing it's like a myth. It was like a dream. It's the nirvana of, of, of dentistry, if you want to call it. And uh, there are many protocols in dentistry, equipments, tools, and machines that provide, uh, painless treatments, uh, from computer, painless injection system.

Dr. Khalid Hannouneh 02:54 And you also like Exactly. And while I was studying this, I found out that there is something called odonto phobia. Okay. Yes. The fear of dentists, dentists or dental treatments and when, I don't have it, but imagine it's, it's, it's the, it's, it's the fourth most common phobia that people as a, as a population.

Dr. Khalid Hannouneh 03:13 Wow. We're talking about 43% of the population. In general, like we are, what, 8 billion? So you're talking about 3.7 billion. Uh, we are like 8 billion, 3.7 billion people would experience the odontophobia in different levels. So we're talking about the odontophobia, where it starts from, from, um, just fear of going to dentist and it reaches up to a phobia level.

Dr. Khalid Hannouneh 03:37 Where you technically cannot control your reactions.

Antonello Croce (host) 03:40 Yeah. What is most For the younger people or for all the It's for, yeah, for both. For both.

Dr. Khalid Hannouneh 03:45 For younger people, it's just for them a new experience as we know. Yeah. Fear of something new. But of course communication with them will play a big role. So if you handle them when they are young, properly, the dentist treats them properly and you give them time, we have something of Tell-show-do.

Dr. Khalid Hannouneh 04:01 For the kids. Yes. So you have to tell them, then show them what is this? And then you start doing it's preparation. And remember the trauma that we cause for the kid at this age will eventually reflect on them for the rest of their life. So you have a lot of people now they come adults. They come to my clinic.

Dr. Khalid Hannouneh 04:19 Yep. With. Phobia. It means that the patient starts shaking on the chair before we start doing anything and they don't remember. But if you go back and dig deeper, and I tell them to ask their parents, did they ever have a bad dental treatment when they were kids? They don't remember it, but yes, most of them they had where it was traumatizing, uh, experience, which resulted eventually to them developing odontophobia that they avoid dentists.

Dr. Khalid Hannouneh 04:44 What leads to. Yeah. Bad dentist situation.

Antonello Croce (host) 04:47 But what are the, you, you mentioned that the, um, uh, patient that come to your clinic. You also have other clinics. Yes, we have, uh, yeah. Other special, but this one is, uh, focused, has the prevention at the center. Yes, exactly. Like you also call it like Yeah. Mouth spa.

Antonello Croce (host) 05:03 Mouth spa. Yeah. It's an interesting word because the idea behind it's, um, it's bigger, you know,

Dr. Khalid Hannouneh 05:10 the idea of coming to dental clinic. Yes. Is not a pleasant thing, neither for you, nor for me. Now it's my work and stuff, but even for me, it was always, even me being a dentist and having my dental checkups or dental clinics, yeah.

Dr. Khalid Hannouneh 05:23 Or even dental treatments was kind of something not very comfortable for me. But of course, not reaching the phobia level now, understanding the importance or the impact. Of this fear of the dentist on the patients as comfort, as follow up, as, uh, as even, even if you were talking about a business of a dental clinic, this is something like the most canceled or no show yes to appointments is a dental appointment.

Dr. Khalid Hannouneh 05:52 This is a statistic. Uh, so you ladies will not miss their hairdresser or nail, they would miss. There, the dentist. You know, why don't you show up? So the idea was to, to find a way to break it when I understood this concept of adonto phobia and dental. So I start looking for ways to do it. Now fast forward.

Dr. Khalid Hannouneh 06:10 This was in 2013, 2014. Fast forward in 2017, I had an interaction with a big, uh, manufacturer, like the most prestigious one in the dental field called it's EMS, you know, of a Swiss company that produces this ultrasonic systems, a prophylaxis systems. And they have just invented in collaboration with the Swiss Dental Academy, a new concept in dentistry called the GBT or the Guided Biofilm Therapy.

Dr. Khalid Hannouneh 06:39 And, um, it was interesting for me, so they have this machine, I brought this machine. To my clinic and we started using it, providing the dental prophylaxis treatments according to the GBT standards, which is a protocol for teeth cleaning. And we managed to provide this dental cleaning painlessly, painlessly.

Dr. Khalid Hannouneh 06:57 Very advanced because you can see, you can, you can, as a dentist, you can see the biofilm, which is a layer of bacteria that forms on the teeth and causes damage to the gums, to the teeth, and eventually it goes through your gums, to your bloodstream, to your body, causing this ongoing inflammation in your body.

Dr. Khalid Hannouneh 07:16 So you might have a chronic inflammation in your gum for two years. Yes. And this means like you have an open wound for two years that has bacteria entering. Imagine what? Does to your heart, to your brain, to your lungs, to everywhere. So it slowly destroys it. We managed to have this GBT and the patients were really happy about the procedure and we noticed that people were coming back more frequently.

Dr. Khalid Hannouneh 07:39 So before with the normal dental clinic people were, were even still, it was painful for them, so they would do it every six months. If they come back, we call them, remind them. We found out with the GBT people were coming back. More often. They were committing more. Yes, exactly. And they were happy with the procedure.

Antonello Croce (host) 07:56 Yeah. So. Um, the machine is something that the patient doesn't understand. I mean, yes. So me as a patient, I am coming to your clinic because I see different approach to it, like, uh, it's mostly as a prevention. Hmm. What do you feel that, um, the patient when comes, what they, um, are expecting from, from the clinic, why they are coming?

Antonello Croce (host) 08:23 They, they might come because of a different idea. Mm-hmm. Uh, I mean, they might know that it's not a traditional cleaning or traditional. Mm. So, because I imagine that the response to, to this approach is. It's good. I mean, uh, as you mentioned, the the patients are coming, uh, back and that's a good thing. Yes.

Antonello Croce (host) 08:45 So they are expecting something, um, different. It was not, uh, out there. Yes. Like, yes.

Dr. Khalid Hannouneh 08:51 So let's understand why is the patient coming back? Yeah. Why does the patient, what, what is the fear of the patient? First of all, the pain. So patient is afraid of the pain when they have this experience of GBT for the first time.

Dr. Khalid Hannouneh 09:05 They understand that it is super nice. Some of them even say that they didn't feel Yeah, the powder on their gums. Okay. That they felt only like a massage of the gum. Yeah. And from there came my idea, massage to the gum. That's a mouth spa. Yeah. Okay. You know, in the beginning I said, I called it oral spa, but it sounds wrong.

Dr. Khalid Hannouneh 09:24 So we changed it into a mouth spa, you know? Yeah. Um, and, and from there we understand. So first pain is eliminated. Second education in dentistry. Yes. Let's be honest, as dentist, we have a duty not only to treat patients, we have to heal patients. Yeah. And we've been for a while, only drilling and filling.

Dr. Khalid Hannouneh 09:48 Caries, drill the caries, put the filling and let go. Extraction, remove the tooth, let go. It's all mechanical. Of course, we are doctors, we are healers, so we have to come back to the roots. Our job is to heal things. And with GBT I found out that we are healing people. We are healing them, not only in their gums and teeth, we are healing them and pro and protecting them from more.

Dr. Khalid Hannouneh 10:11 Serious medical issues in the future that is related directly to their mouth. Imagine now statistics and studies and it's becoming more clear. And you will see in the next five to 10 years, it'll be a main concentration where they will start preventing or treating some general, uh, general systemic diseases from the mouth.

Dr. Khalid Hannouneh 10:30 Yes. So, so this biofilm is, has, has a main impact. So when the patient was coming. Having painless treatment. At the same time, we are educating them as dentists. Our responsibility is to educate our patients, our patients, they don't get, we as people, we don't get the, the awareness of our. Oral hygiene from the school or from the street, or even from the tv.

Dr. Khalid Hannouneh 10:53 It's not an interesting topic. It's a, it's a topic everyone tries to avoid. So the patients when they come, when he, when he or she come to my clinic for me to educate them, to give him the idea. And they never knew because many of us as dentists didn't know. Yeah. That the biofilm has this impact because now science is showing more.

Dr. Khalid Hannouneh 11:12 So understanding that this is an important thing to keep you, well, you go to the gym. Yes, you wake up in the morning, you do your morning routine, you eat healthy, you train, you sleep well. But then there is an issue. You are, you are trying to, to live longer and healthier. And this is amazing and this is a trend now.

Dr. Khalid Hannouneh 11:29 People wanna live healthy life. And after Covid, mainly people started taking more care of their health because they understood that this is the most precious thing you have. So in order to maintain this wellness, you have to eat healthy, train and be psychologically healthy, whatever. Main factor is your oral wellness because it'll reflect on your general wellness.

Dr. Khalid Hannouneh 11:52 That's what we're trying to people understand.

Antonello Croce (host) 11:54 Yeah, exactly. And, and sorry to interrupt, but uh, taking this point, like if we educating the patient from the beginning mm-hmm. From be before, because now we are treating a patient, maybe they already have some problem. So if we started gaining them. Uh, from the beginning.

Antonello Croce (host) 12:11 Mm. Let's say in the future. Mm-hmm. So what, uh, what are we, um, we're doing something, uh, uh, good. And, uh, so what benefit are we having on Okay. With this prevention. Is only dental related? No. Or no?

Dr. Khalid Hannouneh 12:27 Yeah. More. Okay. Thank you very much for this question, because it's a, we call it the million dollar question.

Dr. Khalid Hannouneh 12:31 You know, I'm gonna talk about an experience. The Dubai experience, the UAE experience. Um, some people might feel or think that I'm a biased. Yes, I am. Because I don't think there's someone who can compete with what's happening in UAE. Yeah. We started, you know, remember in the eighties and. Nineties. It was the American dream.

Dr. Khalid Hannouneh 12:52 Now I call it the UAE Dream or the Dubai Dream. It's a place where you, that's why people are leaving their countries. There's a big wave of people moving because in, in this place, they care about people. They care about people wellness, about people life and people happiness. There is a ministry of happiness in UAE.

Dr. Khalid Hannouneh 13:10 Wow. Part of this. Part of this, um, policy. And here, listen, I'm not really, I'm not here complimenting, I'm talking facts. So if you look at facts, something nobody knows because something new. The Ministry of Health in the United Arab Emirates is the first ministry in the world that is technically adopting GBT as a standard protocol soon, standard protocol for the dental hygiene.

Dr. Khalid Hannouneh 13:36 Why is that? Why would. Um, a government invest in such concept because they were, they understood the idea of the importance of the oral wellness. On the general wellness and this, it's not only buying machines and using this protocol, it's also about educating their patients. So now it's the main responsibility of us as dentists to educate, but also the governments and uh, what we call it, the NGOs, to technically start educating people about the importance of the oral care.

Dr. Khalid Hannouneh 14:10 So there are public. Um, health awareness campaigns that high highlights the importance of, um, oral health on general health because this government, they take care of their. Of everyone and of their, uh, citizens that they cover their treatments. Yes. Implants, root, cannels, fillings, anything is covered. Like, it's, it's insane here.

Dr. Khalid Hannouneh 14:35 I've never been, I've never seen any country in the world that adopts and takes care, like covers completely. It's, it's, it's citizens. Yeah. So when you are having a better oral wellness and better health, oral health. You will have less problems. Exactly. And this costs the governments and the insurance companies.

Antonello Croce (host) 14:56 Yes.

Dr. Khalid Hannouneh 14:56 When you have more problems, you have more spending on this. It's not spending, it's a waste. This is a waste When you have more problems, more implants, more the cost, the time, the the effort, even the health of the patients. So now they understood the idea since a while, of course. But the importance of.

Dr. Khalid Hannouneh 15:15 Prevention to avoid these problems. So it's an investment in the future like they always do, you know? Yeah. And I, I, I see this brilliant, honestly speaking, and I believe this will be, uh, I hope this will be an experience to highlight. And from there, I hope you'll ask me the next question about why UAE for GBT clinic, for example.

Dr. Khalid Hannouneh 15:36 I have an answer. Ask me, you know,

Antonello Croce (host) 15:39 okay. I have a question to answer. No, because I don't want to jump to the next part. You know, like, yeah, yeah. So, okay. Why? Why? Why is this? Why choosing G-B-T-G-B-T clinic. So we go back to your

Dr. Khalid Hannouneh 15:51 first question that I didn't answer. I was talking about other stuff. Why GBT? I want to build this idea to reach here.

Dr. Khalid Hannouneh 15:57 Yeah. GBT as a concept is a Swiss concept. You know by the Swiss Dental Academy? It's international concept. Yes. And it is applied in many clinics around the world where the machine is there, the, the dentist, the hygienist, or whoever, dental practitioner is there getting special training to be certified to use this protocol by the Swiss Dental Academy.

Dr. Khalid Hannouneh 16:17 So the clinic is called Certified Dental Clinic? Yeah, GBT certified. And I am trainer for this in the Middle East, in UAE, in Saudi, Qatar, around the place. You know, even in India we did some courses. So technically spreading this knowledge. Now why? To open a clinic that's dedicated for

Antonello Croce (host) 16:34 GBT. Yes. First of all, which, when you say GBT, I also want to mention that this different therapy Yes, but it's dedicated.

Antonello Croce (host) 16:41 It's dedicated for prevention. Yes. To prevention. So that's an important thing to understand. Exactly. Now any treatment you

Dr. Khalid Hannouneh 16:48 do. Yeah. A lot of people do implants now. Exactly. The question, how do you maintain this implant? Unfortunately, the patient thinks that when we get them a, a metal implant, metal screw in their mouth, they become Iron Man.

Dr. Khalid Hannouneh 17:01 Like they don't have decay, they don't have problems. Which is wrong. Yeah. Yeah, because the effort that you do to maintain this implant will be much bigger than maintaining your normal tooth. So people who lose their teeth from, from periodontal issue because of their negligence, I don't do implants for them because they will lose for sure.

Dr. Khalid Hannouneh 17:20 The implant. The implant. So technically we, we educate, we do awareness, and then we start. To do maintenance, the most efficient and let's say comfortable and, uh, clinically proven, supported with more than 4,000 studies, imagine is dental implants, dental cleaning, dental implants, cleaning, done by GBT. So this clinic is there to provide a better experience for the patients.

Dr. Khalid Hannouneh 17:46 I mean, you can see the clinic. You saw the clinic technically, yeah. It's a, it looks more like a spa where we give a feeling of the patient. We, we improve his psychological experience of entering dental clinic. So patients, they enter, they don't know if they're in dental clinic or in a gallery or in a spa.

Dr. Khalid Hannouneh 18:00 They don't know, but it doesn't show anything that they're in dental clinic because we wanna break this center experience. We have a special, uh, people that take care of them. We call them special names that technically. Different changes. This idea, even the dental rooms are not called dental room one, dental room two.

Dr. Khalid Hannouneh 18:16 It's called, uh, according to cities, Geneva room. Oh, that's nice. Yes. We have Interlaken and Retreat. We have, technically we are changing this experience. So when I tell the patient, when I tell my assistant, take care to Geneva patients. Yeah. You know, the experience starting. Yeah. So we work on the psychological part and again, we are dedicating it to do, provide this painless, comfortable, highly preventive and special.

Dr. Khalid Hannouneh 18:40 Dental experience for them to clean their teeth, remove their biofilm, make them feel good, and they come more often, you know, so, so technically it's dedicated. Now, why Dubai? Of course, I always believed, so I had a suggestion and options actually to open other places, maybe in Europe. Yeah, Dubai is the place to start these things.

Dr. Khalid Hannouneh 19:00 Yeah. Dubai was always a place for what people called crazy ideas. Yes. And then we knew that it wasn't crazy. It was a dream ambition that's beyond anyone's expectation, and then it becomes reality. So in Dubai, it's a place where you can come up with these ideas, apply it and explain it to people, apply it properly, and you'll see people how it becomes, it starts from Dubai.

Dr. Khalid Hannouneh 19:22 So GBT Clinic is not only in Dubai, there is now in Lisbon. Yes, there will be in Geneva, there will be in Sydney, there will be around the world. But we are proud to say that in the future, that it started from here and from here, uh, of course Swiss concept, but even the Swiss Academy supported that we started from here because listen, listen.

Dr. Khalid Hannouneh 19:42 Yeah. Whether they like it or not, Dubai is the place

Antonello Croce (host) 19:46 to be because it's the center of, now it's something even deeper because I, I imagine that, um. You say Dubai because is this, because maybe the people who are living here are taking care of themselves more of, uh, for like, um, uh, they understand this concept.

Antonello Croce (host) 20:08 Maybe because. They are the youngest compared to, yeah. Yeah. So they're younger and also they like taking care is a trend of the wellness. Okay. They go running every day, they go. So they like ev taking care also of the, the dental or activity? Well, there

Dr. Khalid Hannouneh 20:24 are many factors here. We have to. First of all, of course we have to understand in this country you have a young population.

Dr. Khalid Hannouneh 20:30 Yes. So people who come to work here are mainly people at the working age between let's say 20 to 50 at 60. Even now young age is extending to 60. I don't see someone who's 60 or 65. Yeah. As an old person, you know, because level of life is improving and. In this country we're talking about big population who are expats coming here to work at the young age where they can give and they can produce.

Dr. Khalid Hannouneh 20:53 So, uh, when we have these people, uh, at this age here, they are also taking care of their health in terms of wellness, in terms of trying to go to the gym, keeps this wellness, in addition to having a general idea. Of the whole country, which was built by the, by the founder of this city, uh, Sheikh Hamdan bin Rashid, in terms of always wanting to be number one in everything and always wanting to, uh, to improve and always wanting to, to be special and apply the latest technology.

Dr. Khalid Hannouneh 21:25 Yeah. This behavior reflected I think on everyone who lives in this place reflected on me personally to be a dreamer. Yeah. Reflected on you to be a dream and chase your dream. Yes. Leave Italy and chase your dream in Dubai. Yeah. Because for us, it's, it's, it's a place where it supports this, this, um. Ideas, this ideas and this behavior.

Dr. Khalid Hannouneh 21:46 So, so people, when they come here, it's more of, yes, they wanna, they wanna do new things, they wanna start new businesses, they wanna create the special ideas. Uh, that's why you, you see a lot of crazy and beautiful and amazing innovative ideas starting from here. And again, I have to repeat and stress. It is not some sort of a compliment.

Dr. Khalid Hannouneh 22:05 I'm making, I'm stating facts.

Dr. Khalid Hannouneh 22:07 Yeah.

Dr. Khalid Hannouneh 22:07 Look at the news. Look at the achievements and look, go out and drive in the city. So everything is on different standard that is pushing everyone to bring the best out of them. That's why you see people. Achieving their best dream here, you know? Yes.

Antonello Croce (host) 22:23 Yes. So wellness here is at first, yes.

Antonello Croce (host) 22:26 Wellness

Dr. Khalid Hannouneh 22:27 is, is first because you have to be healthy all the time. Yeah. To, to be able to, to continue and to produce. Because if it's not,

Antonello Croce (host) 22:35 if this is not good. Yes, exactly. This is never good. Exactly. So, but I am a dental technician. Yeah. If we. Um, do more permission in here. Let's say in, uh, 10 years. There will be, let's just imagine.

Antonello Croce (host) 22:51 Yes. More prevention, yes. But no implant anymore. Less work for you? No. Well, you think this will never happen? This is,

Dr. Khalid Hannouneh 23:02 this is a dilemma. I've been discussing it with my, with my colleagues. Um. There will always be things. So when we work prevention, we work prevention of pathological dental issues that is related to biofilm and bacteria caries, root canals, uh, implants.

Dr. Khalid Hannouneh 23:20 But it doesn't mean that there, there will be no. Everyone that will be like this, there will always be something. And moreover, we will concentrate more on the preventive medicine that we will do other form of treatments into prevention. I dunno what, what it could be, but there will be more prevention technologies.

Dr. Khalid Hannouneh 23:38 But what it will eventually lead to, yes, maybe less patient in terms of, um, severe dental, pathologic, pathologically related treatments, but at the same time, you'll always have. Traumas, you'll always have broken teeth. You'll always have people with decays, you'll always have this. So it doesn't, it doesn't reduce, I see it improving people's lives.

Dr. Khalid Hannouneh 24:01 Yeah. So there will be more mouth spas. Yes. And less scary dental clinics, you know, with, uh, with aggressive procedures. And I see it. I see it. I don't wanna be idealist, but, uh, and a hypocrite, of course. I don't want to have less work. But I want to have more work in the thing that makes me feel good. Yes.

Dr. Khalid Hannouneh 24:21 Where I'm healing people. Now we see it in dentistry. You know, there are a lot of biocompatible material and biometrics materials. So now we have new fillings that technically claims that it restores the dentine, so hydroxy ides and stuff. So we are going into the healing, and this is the future if we try to stop this.

Dr. Khalid Hannouneh 24:42 If we try to fight this, we will stay behind. So I think it's a train and it's moving and we cannot stop it. Never stop. So we cannot stop it, and we don't need to because we have an ethical responsibility as well. Yeah. To support anything that improves our patient's health and the public health, because these patients are my mom, my, my brother, my father, my wife, my kids, you know, so whatever you want to apply what you want a, a doctor or dentist to apply to them.

Dr. Khalid Hannouneh 25:11 You have to apply it to all your clients. 'cause they're not clients at the same day. They are, they are your, uh, people who trusted you. So, so we always aim and try to provide the best. We are not the best, but we always try to be the best.

Antonello Croce (host) 25:26 But, uh, okay. So connecting this point, like more prevention, less issues.

Antonello Croce (host) 25:32 Mm.

Antonello Croce (host) 25:33 That the outcome is good? Yes. Is good for the patient, for the public. Do you think that we as a pro profession, like, uh, all the companies and then these professionals related are doing enough to connect these dots? Or is it just something that's maybe started? Is it starting now? Yes, so,

Dr. Khalid Hannouneh 25:55 so, um, I believe in dentistry, the problem for us was always time.

Dr. Khalid Hannouneh 26:01 Yeah. We, dentists don't have time. We have schedule that's booked. I dunno how many? 10, 15, 20. Some people, they tell me numbers of seeing 30 patients a day and 50 patients. That's for orthodontists because, you know, you go, so they do 40 or 50 a day. Um, we have tight schedule. We don't have time. I. We don't have time for our patients.

Dr. Khalid Hannouneh 26:24 We don't have time for our family in the first place because we have to give our time for our patients and then we come to the clinic, we don't have time for our patients. So we spend our life running in these vicious circles, and we are as dentist, the only. One of the very few doctors that we do operation for every single patient.

Dr. Khalid Hannouneh 26:42 Yes. I mean, other specialties, you do consultation, but technically we do an operation because once you do, whether it's a cleaning or a filling or a extraction or a period treatment, it's a surgery. So every time the patient comes, you are doing cutting in healthy tissue, which is rated as surgery. Surgery.

Dr. Khalid Hannouneh 26:57 The idea is we don't have time. This is giving us stress, so we don't really, we lost, we lose track over years. Yeah. And we lose track. We lose attention to ourselves. To why we studied this, to why we have to do this, and to eventually we forget to listen our patient, to listen to our patients, to see what they want really, and how we can really improve their experience.

Dr. Khalid Hannouneh 27:19 I try as much as I can to not lose this over years. When you grow in your work or in your business, you, you start feeling that, oh wait, I am losing this like life or this career is swallowing me and technically I don't want this to happen. So I. Put breaks and I go back, I let some steps back. Okay, listen, less patience today, please.

Dr. Khalid Hannouneh 27:41 I want to have more patience with each patient. I want to have this human relation. Yeah. Where I listen to the patient genuinely need, I don't hear the patient. I listen to the patient and give them what they really need. And if they don't know what they want to guide them to, what they actually need for their mouth health, and now I say general health, so GBT Clinic by Dr. Khalid.

Dr. Khalid Hannouneh 28:04 In the JBR is not a center for prophylaxis, it's a center for mouth and general wellness, where we provide this with the most comfort and the least pain possible with the highest health outcome possible.

Antonello Croce (host) 28:20 The good, the beautiful. Beautiful. And the truth. The truth, exactly.

Dr. Khalid Hannouneh 28:24 That's amazing. And you know, this is from Plato, you know?

Antonello Croce (host) 28:27 No, what, yeah, it's from Plato, from, uh, from Greece. You know, he was, it's his concept about, about the truth. Yeah. Uh, it's, it's, uh, technically he says that it should be the truth. Should be good. It should be beautiful and should be true. That should, you know. True. Yeah. So this is the GBT, you know,

Antonello Croce (host) 28:45 this is interesting, interesting innovation and, um, if we think of what has been done here, there is a new tech of course, but the, the tech is, uh, the last, uh, uh.

Antonello Croce (host) 28:56 It's, it's important. A lot of tech, tech, I mean, this

Dr. Khalid Hannouneh 28:59 machine has 13 patents, you know? Yes, yes. Of tech.

Antonello Croce (host) 29:03 But, uh, there is, um, behind this also, uh, something that it's bigger, like taking something that was out there was, uh, like, uh, going, treating an a secondary and, um. And to build it, uh, as an innovation, like make it at the center, make it with the new technology.

Antonello Croce (host) 29:27 But, uh, the prevention. Has always been out there, but, uh, uh, not treated them. Maybe as we should treat the prevention as Khalid is now recommending how to, to, to do it. Okay. Interesting. Uh, uh, interesting innovation that we have heard today. And, um, to let you understand better, let's see together, if we remove all the biofilm, all the.

Antonello Croce (host) 29:56 Uh, the problem with doing this therapy constantly, does this mean that we will not have any problem anymore? So

Dr. Khalid Hannouneh 30:05 let's, uh, divide the answer into options, dentally and generally. Okay. General health and dental health. There is a study done by two major doctors. Um, my colleague dentist will know their names, professor Linda and Axelson.

Dr. Khalid Hannouneh 30:20 These guys, they technically. They're the authors of most of the books we study in university about periodontology. These two are gum health. These two, they have done one of the clinical researchers, one of the longest clinical researchers in the field of medicine and dentistry. They did a clinical study with 30 years follow up, 30 years.

Dr. Khalid Hannouneh 30:40 They started the study in 1974 and they finished it in 2004. 30 years they were having their patients coming for dental cleaning where they were controlling the biofilm, doing disclosing for the patients, removing the, the teaching, the patient how to brush properly because it's a big part of the awareness patient health at home.

Dr. Khalid Hannouneh 31:01 What they do at home, it's half, 50% of what we do. Yeah. So they were teaching their patients how to clean and they were removing the biofilm completely. And they were doing this for them regularly for 30 years. The conclusion was when they control the biofilm, there were no more caries. Wow. And no attachment loss.

Dr. Khalid Hannouneh 31:19 Now, there are studies. I mean, you can see the studies are there, the references you can even provide, whoever wants details about this episode and they want details about the study. I can provide you the resources, the source of these studies actually, and, and technically it it, yes, it was the mouth Nirvana.

Dr. Khalid Hannouneh 31:38 Yeah, so controlling biofilm resulted in no more caries and no attachment loss. This was done on around 257 patients now. Does this mean that we will eliminate this? I can tell you no, but we can reduce it to the percentage of 99 point something or 98 even. Even if reduce it to 90%, you are improving the life span of your teeth income and 90% of you do that.

Dr. Khalid Hannouneh 32:06 If we will debate about a hundred percent, then I'll tell you, yes, you win, but you lose the other 90%. Now this is dental part. General health part. There has been, I have a, a friend of mine, uh, a very amazing dentist in London. Her name is Victoria Samson. I say hi to her, maybe if she sees this, she's done a podcast and it went really viral.

Dr. Khalid Hannouneh 32:25 A very interesting thing she was talking about, which is they found out that early onsets or, or, uh, or Alzheimer, you know Yeah. Is related directly Wow. To the oral wow bacteria. So technically controlling this oral biofilm. Is resulting in either delaying or even not onset. I don't have the exact details of this study to be honest with you, but it is there.

Dr. Khalid Hannouneh 32:50 I also can share it with you. I don't have it in my mind now, but we know now that this is reflecting a lot of things. You're technically avoiding a lot of problems and science is showing us a direct link now between this oral biofilm and a lot of things. When we say. Alzheimer's. When we say lung cancers, when we say even, you know, in Covid there has been a study that said they did it on a, on around, uh, 97 patients.

Dr. Khalid Hannouneh 33:18 Yeah. Over six months. Those patients who had oral infection were nine times more susceptible to death of covid than those who didn't have oral infections. Wow. That's interesting. So let's just, let's simplify it. Take care of your mouth. Of your teeth, of your gums, because it is directly related to your general problems.

Dr. Khalid Hannouneh 33:42 You might have other problems in other places of your body that you do not understand and you treat. You're treating the wrong thing. Go treat the cause, the source. And remember this example, if you cut your hand and you have bleeding, the first thing to do is to wash it. Clean it disinfected with alcohol and cover it so it doesn't get infected.

Dr. Khalid Hannouneh 34:01 Imagine every time you brush your teeth and you see blood coming from the gum. Yeah, it doesn't bleed. Now it's open wound all the time. You just sew it because you were brushing with a hard toothbrush. But this wound is open all the time and there is 10 billion bacteria in your mouth that lives in your mouth.

Dr. Khalid Hannouneh 34:17 Normally we call it the microbiome that is technically going through the bloodstream. Going to different organs in your body and causing inflammation, and this bacteria is running in your mouth for years. Sometimes people come to me, tell me I want to do whitening and I test their gum. They have flabby gum with a, with an eight millimeters pockets.

Dr. Khalid Hannouneh 34:37 So again, if you keep on treating your, your dentist like uh, uh, in a consumer way where technically you are going to buy what you want, not what you need, yes, that's a problem. That's why please. Go to your dentist appointment every four or six months. Yeah. Because once you feel something, it might be already too late and the treatment is more complicated if you go preventive visits.

Antonello Croce (host) 35:01 Wow. I feel like now I want to go wash my teeth. Okay. So, uh, it's important to take care also of your oral cavity. If you're taking care of your body, you are going running, let's go and take care, more care about your oral cavity and you'll have less work later in the future. Yes, they do this. Yeah.

Antonello Croce (host) 35:26 Thank you Dr. Khalid, for coming today and sharing your knowledge. Thank you.

Dr. Khalid Hannouneh 35:29 Amazing interview. Thank you very much.

Antonello Croce (host) 35:31 See you next time.