Behind a Smile with Dr. Shauntel Ambrose

Balancing the Art and Science in Paediatric dentistry and Myofacial Pain Syndrome with a Family Touch

• Shauntel Ambrose

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Discover the intricate tapestry of family, mentorship, and healthcare with Dr. Chelsea Cahi, a dentist who has integrated and grown her passion for Paediatric dentistry and Myofacial Pain Disorder into a blossoming patient-centric addition to the family dental business. Growing up amid the hum of dental drills, Dr. Cahi joins us to share how she's contributing to her family's legacy at the Cahi Dental and Prosthodontic Practice . Amid tales of her formative years and the wisdom gleaned from her father and uncle, she dives into the delicate intricacies of paediatric dentistry and the subtle art of managing stress and bruxism induced TMJ disorders with a philosophy grounded in patient education and non-invasive techniques.

When confronted with the sometimes harsh reality of competitive behaviours in the dental field, Dr. Cahi stands as a beacon of integrity and professionalism. Her stories, rich with the details of navigating these challenges while preserving the trust and well-being of her patients, serve as a masterclass in maintaining one's ethical compass in the face of adversity. These candid conversations also unravel the complexities that today's healthcare professionals face, offering solace and strategies to those striving to uphold the highest standards in their practice.

Finally, let Dr. Cahi inspire you as she outlines the blueprints for forging a personal brand within the competitive landscape of dentistry. With a focus on authenticity and patient connection, she articulates the importance of distinguishing oneself in a crowded market. Whether you're a healthcare professional seeking wisdom on career advancement or simply looking for a dose of inspiration from someone who's carved out a successful path, this episode promises to ignite your ambition and maybe even spark a little joy in your journey. Join us for an episode that celebrates dedication, skill, and the personal touch that makes all the difference in the world of healthcare.

Dr Shauntel Ambrose:

Hello and welcome to Behind a Smile. I am Dr Shauntel Ambrose and I am a dentist. I host a healthcare business podcast where I interview healthcare practitioners around the world, sharing tips on how to improve your healthcare practice, innovate and grow, while living your best life. We share products and information from healthcare partners that can help you in your practice journey, be it a startup, a family-based business or a multidisciplinary healthcare team. Most of the information provided here is based on personal experience and opinions. Of the information provided here is based on personal experience and opinions, so please supplement what you learn here with approved research, studies and professional advice. Thank you to everyone who has subscribed and I invite you to join our community. If you haven't, we would love to hear from you. If you would like to be on the show, drop me a mail at behindasmile2@ gmailcom. Let's make it happen together. So hello everyone.

Dr Shauntel Ambrose:

It's Shauntel once again and I am very excited to present to you Dr Chelsea Cahi. So we're excited to have her in the studio today. She's been absolutely gracious to give us a little bit of her time and she's a busy lady, so I just want to introduce her before we get into the nitty-gritty for today. So she is a graduate from the University of Witwatersrand and she managed to get the Dean's Golden Key Award for Academic Excellence. She's completed her year of community service. And then Chelsea joined her dad and her uncle in Cahi Dental and Prosthetic Practice in Parktown North. So I'm really excited to have somebody talk about oral facial pain, tmj management, what we're able to do with that and a little bit about her other love, which is Peds. So we welcome you, Chelsea. Thank you for being here today.

Dr Chelsea Cahi:

Thank you so much. I'm so excited to be on this podcast, so thank you for having me.

Dr Shauntel Ambrose:

I want to know what is it like growing up in that atmosphere you not only had dad as a dentist, but you also had your uncle as a dentist and can you just share with us what is that like growing up in this dental business that's a family business and how did that influence you and your career path?

Dr Chelsea Cahi:

So growing up in a dental world you could almost call it it didn't really have much influence on me until I was around 16. When I was thinking, what am I going to do with my future, I always wanted to do something medical. It was a non-negotiable. I just wanted to do something like that. And when I was about 16, my mom actually said to me you know, charles, maybe you should consider dentistry. You should go and shadow dad and uncle Neil and have a look at it. It's a wonderful profession, especially for a woman. Your hours are flexible and I hadn't really thought about it up until then. And then I started shadowing them and, to everybody's surprise, I actually enjoyed it and found it quite rewarding. And that's when the whole journey began and it's been absolutely wonderful.

Dr Chelsea Cahi:

I couldn't have asked for a better support than my dad and my uncle during my studies. Really, they helped me tremendously and I actually felt only when I really joined the practice after my degree is when the true learning actually began, because I have learned so much from them post-graduating that it's actually priceless and to be together is wonderful. I mean, people ask me every day how do you work with your father? Family business can be tricky, don't? You? Guys clash and I always joke around and say you know he drives me mad, that's just because he's my dad, not because he's my boss. I mean, you couldn't wish or ask for a better boss or an employer than my father. But you know he drives me mad because he's my father, you know, and he's on my case all the time Also. Luckily, we've all got different interests in different fields, so our work doesn't really clash. But it's a great environment. I love it. I couldn't ask to be part of a better practice and I'm just very lucky and fortunate.

Dr Shauntel Ambrose:

You know, listen, I think that we've spoken on the show. I put a lot of emphasis on mentorship and I find that it really is something that in your undergraduate year, you'll find that there are a few individuals that have almost a background with their mentorship. Find that there are a few individuals that have almost a background with their mentorship, and then there are a few individuals that are seeking the mentorship and then there are a few individuals that are just really just finding their feet. And I've been encouraging since having the podcast. I've been encouraging us as professionals, as healthcare professionals, to start looking at mentorship as not something that is competitive, but it is something that can really grow individuals and practices and people at large. So it's exactly what you've said earlier. You know you could not have somebody better than your own dad because your mentorship starts so young. You have an expert in almost every field in dentistry and you do a significant amount of aesthetics as well. So what is your focus in the practice?

Dr Chelsea Cahi:

So I practice general dentistry, and so there isn't one aspect that I don't do. I mean, I see all my general dental patients, but I think you could call my niche is maybe two aspects. Peds, definitely, I've managed to build up quite a solid foundation of pediatric patients and I also do quite a lot of TMJ management. A few years ago I actually did a fellowship with a maxillofacial surgeon in Rosebank. He subsequently immigrated to America and he specialized in TMJ and oral facial pain and I learned really a hell of a lot from him, and so I've almost implemented that now into my practice. So I do that. I also do a little bit of non-surgical facial aesthetics nothing major, I'm very conservative, but I do do it as well as just the general implants, things like that.

Dr Shauntel Ambrose:

You know, there are a few aspects that I'd love to touch on. So I'm excited about TMJ and what people are doing in terms of management. So can you give us a little bit of a background with what you're doing with TMJ?

Dr Chelsea Cahi:

So usually I mean South Africa, or just every day. I mean we live in a very stressful environment and I mean it must be every day, or every second day we're seeing somebody in the practice that's coming in and presenting with pain or tenderness in either their jaw joint itself or the muscles around the jaw. People are waking up with headaches, they're struggling to fall asleep, struggling to stay asleep, have tightness in the jaw, just that general sense of feeling unwell and fatigued. And a lot of the time a TMJ problem is misdiagnosed and people think it's just head and neck tension, or it's earache or it's sinus pain or it's a nerve problem. So you really have to be quite on the ball to get it right. And when we do get it right, it is rewarding.

Dr Chelsea Cahi:

It's a difficult thing to manage because we try to keep our management conservative, depending obviously on how severe it is. Yeah, we try really hard just to get these patients out of pain. A lot of the time with TMJ it's irreversible. So once it's already in the jaw joint and people are hearing like a clicking or there's a slide or something along those lines, it's almost irreversible unless you want to go and have surgery, which a lot of people don't, and then we just try and manage the symptoms and manage your pain and just try and improve your day-to-day life.

Dr Shauntel Ambrose:

So are you giving any bite plates, and do you do this over a number of different sessions, or how do you structure that program?

Dr Chelsea Cahi:

So usually it's. I mean, if I see somebody and they're suffering, obviously after we do an examination or consultation, depending on how bad it is, I often will. It is a process. I don't like to just throw everything at once, because different things work for different people and I like to see what's going to work and what's not going to work. For example, some patients actually require Botox or trigger point injections into those muscles to relieve that tension.

Dr Chelsea Cahi:

But it's not my first line of treatment because you know, then if I do that and I give a bioplate and I recommend physio, then we don't really know what's working and what's not. So I usually start, usually with a course of medication just to try and break that spasm for about 10 days. Most, 99% of the time I always encourage my patients to get a bite plate purely just to protect their teeth number one and also just to try and break the habit of that constant clenching that they're doing on a daily basis, because a lot of people think, oh, we only clench at night. But if you're clenching at night, you're clenching in the day and people just don't realize that. So just to try and break the habit and I've got a great team of physios that are often refer patients to try and relieve that tension and then, if that's still not relieving their symptoms enough, that's when I start suggesting trigger point injections into the muscles to try and break that spasm.

Dr Shauntel Ambrose:

You know, patients don't know enough about how these spasms can actually interrupt the quality of life. Yeah, absolutely.

Dr Shauntel Ambrose:

It's almost as though we don't have enough education out there.

Dr Shauntel Ambrose:

We just don't have enough information out there and in terms of us being practitioners we haven't really participated at that purposeful treatment level for the patients.

Dr Shauntel Ambrose:

When we do find them, when I speak to some of our colleagues, they often say it's quite a difficult patient because they often don't believe that a spasm from your jaw can result in a headache, in neck strain, in a backache, in shoulders paining.

Dr Shauntel Ambrose:

You know they just think that it's a medically related condition, it has very little to do with their teeth and it's almost like you have to go to this idea of convincing them that it actually is the stress coming from a jaw and from a joint, and for a long period of time, because by the time they really present with that amount of pain they've tried a lot but they haven't tried what works because they just have been lost in the system of pain. They'll go to the physio or they'll go to their medical practitioner and they'll get some sort of advice. I know a lot of patients that start at the chiropractor and never are advised to go and see the dentist. A really great thing to do is ask the patient to go and maybe consult with a dentist that is looking at TMJ, where they may be able to assist with that pain and may be able to find those trigger points and really we could work together in collaboration for something that could really help patients. So congratulations on that.

Dr Chelsea Cahi:

Thank you.

Dr Shauntel Ambrose:

Now listen, I've been involved in PEDS for a long time. I have post-grad in pediatrics and it's one of my special love jobs. I think you either love it or you don't. I work with my husband and he's a guy that I think that he's just been blessed in that he can do great surgery and he's one of the few men that I know that can actually work on children with patients. So I don't know how you get everything in life. You know I want to know. Now, how did you get into that? I call it a little micro speciality and those of us that are highly pedantic in the field and that listen to me, you have to forgive me but I feel like it does. Even though we don't get regarded as specialists, what we do is very specialized and I'd love to hear how you got onto that journey and what led you there and how's it all going.

Dr Chelsea Cahi:

So I've always loved children. I have a huge love for children. I come from a very big family, always been lots of little kids around me, so I think it's almost come naturally to me to deal with children. When I was studying our pediatric course, I mean we weren't overly exposed to too much clinical work, but I did used to enjoy it a lot. And when I qualified I actually joined the Pedodontics Society of South Africa where I headed up the outreach component of the society for a few years. And that's when my love for pediatrics really started. Because we used to I used to set up clinics and we used to do free dental care to a lot of underprivileged children all around Kauteng. And then we've always had a lot of underprivileged children all around Kauteng and then we've always had a lot of children coming to the practice. I mean my dad's very good with them and they love him. And then when I started, I think my dad almost not lost his patience, but I think he saw that the kids maybe preferred me, I think, because when they see a young female it's less daunting to them than seeing this big man in a white coat. And that's sort of just how I got into it and obviously I'm in the space.

Dr Chelsea Cahi:

Now. A lot of my friends and colleagues have children and they start bringing them to you or it's. I often go to schools and give talks to the kids and I just always try and relate to them and I think that's a huge thing, just to try and relate to the kids, and now it's almost like I've got all these little friends. You know that I wouldn't really say they're my patients, they're just my little companions that I see every six months and I love it. I mean, it's stressful, don't get me wrong and it can be incredibly frustrating, because what will take you 15 minutes to do on an adult can take you 45 minutes to do on a child, and if the parent is neurotic and anxious, then that's a whole other ball game in itself. But when you get it right it's great and it's very rewarding and it's definitely adds sunshine to the to my practice, I think.

Dr Shauntel Ambrose:

Yeah, well, it's very special to to my practice, I think, well, it's very special to do, like I said, well, I'm slightly biased because I've had a special interest in it for a really long time.

Dr Shauntel Ambrose:

Nobody wanted to see children as a special interest because it took so long to do to a little person what you could do in a really short time to an adult, absolutely person, what you could do in a really short time to an adult, absolutely. And did take growing the fraternity, getting more information out there. The Peter Dantic Society has been absolutely instrumental in South Africa to be able to give us a little bit more assistance with knowing how to treat children better from a worldwide perspective, because we're going to be having IAPD here in Cape Town soon. So I really really think that the more kids that we are able to help, the better we can control disease. So when you go out to schools I'm sure you're giving a lot of information out. But I also know that as a practice that you guys offer a lot of philanthropy and I want to hear a little bit about that because it's very special.

Dr Chelsea Cahi:

So we've always been a practice that firmly believes in giving back and it's not really something that we like to advertise too much because we feel that it's not necessary. We like to keep it close to home. But about once a year or every year we do adopt some kind of children's organization where we offer the children free dental care and treatment, obviously not all the work but the emergency work that needs to be done. So all the children will have consultations and cleanings. We do fissure sealants and then if any of the kids need extractions or fillings or hypotenuse things like that, we do do and we just try and educate them and promote dental awareness, promote oral education. And a big part in it is actually educating their caregivers. Because these kids that we see are young, they're little, some of them are as small as two years old, so we can't educate them and expect them to know everything. So it's always about that point of educating the caregivers things. So it's always about that point of educating the caregivers.

Dr Chelsea Cahi:

And we also I mean we must see maybe three or four patients a week where my dad does a pro bono. He doesn't charge patients, he will never turn anybody away. He's definitely instilled that in all of us. It's part of our mission statement. If somebody's in pain or they're suffering, under no condition do we turn them away and we try and help people as much. No condition do we turn them away and we try and help people as much as we can. Um, we we lucky and we bless that we do have such a wonderful and thriving business, but we don't turn anyone away. Even if patients can't afford a full private rate, we do always try and compromise in some way. So it is something, something that we love and it's close to our hearts and, please God, we can continue to do this.

Dr Shauntel Ambrose:

And so I really applaud you and I applaud the business at large for being able to really commit to it. It's a real commitment when you have to see children and there's quite a few of them Plus, you know what you say is. It really shows how much of pediatrics you do, because the caregivers are really. They are the guardians for those children and they make the decisions for them. Often the children are not in a position, even as they grow older, to make their own decisions Absolutely, and to educate them really does get you to that point of being able to change lives.

Dr Shauntel Ambrose:

So very well done for your commitment, your annual commitment, and I love the idea that it's done with such a lot of grace. I know that it's not something that's publicized too much. You keep it to yourselves. It's something that's in keeping with, I think, the grace and the incredible integrity with which you are presenting the philosophy of health. You know so it's an old school idea, and I think that it's part and parcel of what I see as your mission statement, as your business offering and as your family profile as a business.

Dr Shauntel Ambrose:

Now I know that your uncle, emil, does a lot of prosthodontic work. I always like touching bases on the family at large, always like touching bases on the family at large, as well as your mom. I know your mom plays an important role in just keeping everyone together and just, I think, sewing the seams of the Kahi fabric, and she does that really very well, even though she doesn't often need to be in the spotlight about it. I touch base on that, but I think that it's really something that all of us that want to move towards growing our practices. You put out there a lot of really great information. You stand by what you do. When things go wrong, you also talk about it.

Dr Chelsea Cahi:

You know and.

Dr Shauntel Ambrose:

I really respect that. I really respect that. I revere that, because we don't often talk about the things that go wrong, but they go wrong and you know, as dental professionals, as healthcare practitioners, we often have our backs up. That you know. Listen, this didn't go ideally, it didn't go according to plan, but I can tell you in my 20 years and I've, I mean, I'm a speaker for dental protection Not everything has gone right. We, just by being able to speak to each other as a fraternity rather than as just being able to see each other as competitors, I really enjoy that level of integrity. It's something I applaud.

Dr Shauntel Ambrose:

Every Now we're going to talk about the hard stuff, because on the podcast, I talk about hard stuff and as we go on, we, as you know, our podcast was born from the fact that, post-covid, many practices actually went bankrupt. You know, to get back on that, on being able to be busy and to be able to afford the busyness that years and years has given you reference to, we've had to start. Many people started from scratch all over again and I find that people are finally finding their feet. Despite the way the economy is looking, they're finally finding their feet in South Africa in healthcare.

Dr Shauntel Ambrose:

What I do want to talk about is, as we're growing and as we're diversifying, there is this competition that we're finding amongst our healthcare and I want to ask you you're such a well-positioned practice. You must be seen by other dental practitioners, other healthcare businesses, as being one of those people that are taking market share. How do you respond to these competitive behaviors now from colleagues? Some of them are advising our patients. You know to go and seek sort of litigation and inadvertently they try to gain those patients and you know this does happen in every industry.

Dr Shauntel Ambrose:

I'm not only talking about healthcare. So how do you respond to these competitive behaviors? Because you, for a really long time, are part of a business that has withstood the test of time. You know you would have gone through the waves and this would not be the first and it certainly won't be the last, but know you would have gone through the waves and this would not be the first and it certainly won't be the last. But how do you respond to this? What advice do you have to us as practitioners who are still early in the game?

Dr Chelsea Cahi:

Yeah, sure that's a question and it's a hard question, but it is something that we all go through. I mean, I don't think there's one healthcare professional that can say they haven't experienced some sort of professional jealousy, if you may call it, and also I don't think that there's one healthcare professional that can say that they haven't had a complication, because we all experience these things. I mean, I'm sure everyone in their life that's taken out a tooth has experienced a dry socket or something along those lines. Things happen. But in terms of how I deal with these sort of, say, professional jealousy or colleagues acting the way that they act, to be honest, lucky, I haven't experienced it myself, but I have seen substandard work from other colleagues. We all have. I don't think anyone has seen something from someone else in their career and it hasn't been great, but I don't know.

Dr Chelsea Cahi:

I think there's absolutely no excuse to run down a dental professional or a fellow colleague of yours, and I think people need to remember the Hippocratic Oath that we all took when we graduated and that being ethical and having an ethical practice is far more important than having a busy practice and I'm quite big on that and I'm quite solid when it comes to that. And even when patients request certain things, if I feel that it's not ethical and it's not the right thing to do, I won't do it. And if they want to go elsewhere to practice somewhere else that is going to do it, then then they must. But I like to sleep comfortably at night knowing that I'm doing the right thing, and I mean, if I see something from a colleague of mine that is substandard, I'm more likely to pick up the phone and phone them and discuss it with them, and I will never say to the patient oh yeah, this person did that. They should never have done that.

Dr Chelsea Cahi:

You know, lucky, you came to Cardental. I mean, I just don't think that it's ethically right at all. But everyone to each to their own, and I just think people just need to remember that if you're ethical and you practice with dignity and you have integrity, the people will come, people want to see an ethical practitioner and the business will come and money will follow. But your reputation is everything and that is one thing that I must say. My father's instilled in me is that money comes and goes, people come and go, but your education and your reputation is something that nobody can ever take away from you and it will follow you wherever you go. So you need to always carry on learning, carry on your education, but also make sure you keep a good, clean reputation, because that's something that, once there's a mark on your reputation, can stay with you for life.

Dr Shauntel Ambrose:

I appreciate that, because these hard things but those tips are really the baseline of integrity and I think it does see you through in terms of a long and really a rewarding career, which I think all of us signed up for when we first started up and we had our dreams initially. I'll tell you when I was humbled and when I reached a point of knowing for sure that you can never judge another practitioner is. I was quite early on in my in my business and I had completed my dip in in pediatrics and I had been referred a patient that was sent as uncooperative and they had fillings in their mouths and all of the fillings were not great sort of falling to pieces and they were charged for it and whatever. And so you know you hear these two perspectives, you hear the patient's perspective, you hear the doctor's perspective and you're just there to somehow mediate that and try to move them in the right direction. And it was the most humbling experience when they sat in that chair and I promise you it took me a close on to an hour and 45 minutes to do three fillings and I thought to myself you know I don't consider myself a particularly bad clinician, but on a scale of one to 10, those were the hardest feelings I've ever done.

Dr Shauntel Ambrose:

It was, you know, uncooperative was, I think, a really lovely way of putting it. It was just so much more the child gagged. There was such a lot of saliva. If we were trying to suction they got scared of the suction. The mom is sitting with the child in the chair, so there wasn't enough space for you to work in. And it humbled me because when you get and when you look in someone's mouth and you're thinking that that just happened because you had a lovely rubber dam that somebody tolerated and they tolerated everything else that needed to go, with a beautiful, perfect filling, without any complexity, those are the best days that you can get and they, for me, remain my luckiest days.

Dr Chelsea Cahi:

Absolutely.

Dr Shauntel Ambrose:

And so what you're saying is really so significant. But for us just to be able to practice with a level of integrity is a tremendous thing, and I think it still keeps me happy in what I do, no matter how hard the days get, and I will say that dentistry is one of those hardest careers that anyone could choose Absolutely.

Dr Chelsea Cahi:

And it's so much more than just the mouth. I see patients, I look on the day sheet and I see this and I start getting anxiety because I'm anticipating that it's going to be so difficult. It's a bit of a difficult patient and they're very anxious and I've got to do this filling right at the back of the mouth and I don't know how I'm going to manage in this. And then it's actually my uncle, neil. He's a prosthodontist. He actually said to me you know what, you just got to do it. Don't think, just go, you know, and the patient sits down, just do it, block everything out and don't worry about anything else. That probably was one of the best advice he's ever given me. And now I try to just say, well, I've got no other option, no one else is going to do it, I've got to do it.

Dr Shauntel Ambrose:

You just do it you know, listen, we have our daily stresses and I want to know what keeps you looking so beautiful, so ready to go with this beautiful attitude, that it's a can-do attitude. You have a positivity about you. What are your daily stress reducers?

Dr Chelsea Cahi:

Probably definitely. Exercise is my biggest thing. I try and exercise every single day. If it's not a HIIT class, I try and do a Pilates or a barre class. I play tennis at least once a week and I love paddle. That's a huge thing. And then I just try, and when I leave work, I leave work.

Dr Chelsea Cahi:

I try not to bring that stress home with me and it has been a problem in the past because I do. I am that kind of person that absorbs everybody else's stress and then it feeds into me and I've really had to work on that. But yeah, I've learned to just leave it all behind and say I'll have to deal with it tomorrow or the next day and then just spending my free time with people that I love the most in my life, you know, and my godchildren, who are just everything to me, and my family and my friends, and and also just being outside is a huge thing, I know, maybe just going for a small walk and things like that. And I mean, when worse comes to worse, then I just tell my father you must see the patients and leave me alone, that's what it means really is having him there we must say that if you have that, that backup person, it really does help.

Dr Shauntel Ambrose:

You know, there are days where even you yourself you just need a little bit of a breakaway. Where do you see dentistry in SA?

Dr Chelsea Cahi:

Sure, that's a very loaded question because I mean I suppose it goes hand in hand with where we see SA in the future. But I still believe that some of the best medical and dental professionals in the world have qualified from South Africa and I think that dentistry in South Africa has got a long future ahead of it. I mean people, everyone needs a dentist. I mean, if you've got a sore tooth, you can't fix it yourself, you have to see. You can't go onto Google and find what must you do? People need a dentist.

Dr Chelsea Cahi:

And about two weeks ago my dad actually visited Wits and he went to see the new oral health department and he actually was completely blown away. He said it's amazing. It seems like there's great technology, a great space for learning, and so I think that dentistry in South Africa has got a long way. I think we're very much up there with the trends and technology and new things that are up and coming. But I just hope that we can just get this country under control so we can regain that worldwide respect that we've always been known for.

Dr Shauntel Ambrose:

But please, God, I'm so grateful for your time. Thank you.

Dr Chelsea Cahi:

Thank you.

Dr Shauntel Ambrose:

Congratulations and keep on doing what you're doing. It's fantastic, thank you so much for having me.

Dr Chelsea Cahi:

It was great. I was very excited to be part of the show.

Dr Shauntel Ambrose:

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