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The ‘boutique’

dental practice
Dr Marcos White of The Courtyard in Huddersfield gives us an in-depth
interview on how he has combined experience, style and exceptional service to
create a unique, award winning dental practice. Versha Miyanger finds out more

VM: Can you tell me a bit about your and serve in bars while away but quickly found the rest is history.
background, qualifications and postgraduate out how little they pay you to pick apples and
training? had a change of heart! So six months into the VM: When and why did you become a practice
MW: Let me paint a picture. At school I was trip we arrived in Sydney and I had sorted the owner?
good at art and design and also sciences. I necessary paperwork en route to work in Oz. I MW: On 5th August 2006 I signed for my
wanted to go into a design career but my dad secured three jobs in the Central Coast that in- practice. I remember vividly the song that was
told me it was an overcrowded marketplace and volved living in the dentists’ houses while they playing on my IPod that morning as I walked
I would struggle to get a job. He suggested I use were on holiday, driving their cars and swim- to work from the train station. I remember the
my aptitude in sciences to pursue a vocational ming in their pools. And doing their fillings. nerves in my stomach. I remember being aware
degree. I decided on dentistry. White fillings. This showed me another side to that my life would change forever from that day
My aptitude in science turned out to be dentistry that differed massively from what I forth.
somewhat relative as when it came to A levels had seen and showed me that big white fillings I became a practice owner by accident. By
I was the weakest in Maths and Chemistry and worked. default. I became a practice owner because my
my predicted grades reflected this meaning I When I returned to the UK I took an as- boss was emigrating and I wasn’t prepared to
only got two offers for dental school, Leeds and sociate job at ‘The Courtyard Dental Centre’ in have a new guy come in and be my boss. That
Glasgow. Huddersfield. Alan Neve showed me an empty was as far as my thinking went on the matter.
I preferred Leeds and put that on my UCAS room with his bicycle parked in it and told me
form and pulled out the grades required surpris- that there would be a surgery in there within VM: How did you build your business?
ing my secondary school teachers. University three months and that I would be building an MW: In the early days of owning the practice I
was fantastic fun and I met many inspirational NHS list from scratch. I knew my dentistry was put in a bid to increase our NHS contract from
tutors and lecturers but never shone in particu- a little rusty from lying on beaches so his en- £384k to £500k, which was successful. We
lar sitting retakes in first and second year. ergy and enthusiasm for dentistry clinched the took on more patients, built another surgery
If we now skip forward to my VT year in deal for me and convinced me this was a place and grew in that way. Over time I was carry-
Nottingham and a 99.9% NHS practice where I could learn. ing out more and more private treatments on
everything was amalgam, dentures, extractions A short two years later Alan told me that he my NHS patients and it became apparent that I
and plaque. I was earning very well but became and his wife were emigrating to New Zealand would be able to attract a private list that would
quickly jaded and decided to take a year out and did I want to buy the now two surgery fill my time.
to go travelling. I had intended to pick apples NHS practice from him. I said yes and much of It was at that time that my team and I be-

56 Aesthetic dentistry today March 2011 Volume 5 Number 2


Practice profile

gan going to Chris Barrow workshops. Chris


Barrow was instrumental in changing my
thinking in certain areas, reinforcing my beliefs
in others and giving me the confidence to carry
out parts of my vision with conviction at a time
when I was very inexperienced in business and
dentistry.
The execution of my vision was the next
stage. In 2007 I was given the opportunity
to purchase the third adjoining terrace of our
premises. This coincided with my decision to
take a private list and so began the plans to
expand and refurbish the practice. This also
coincided with the height of the days of banks
throwing money at dentists.
A local architecture firm drew up plans.
We put these to tender and chose the most
expensive quote which was from the company
who fit out all of Paul Smiths boutique clothes
shops throughout the UK. The build was flaw-
less from a technical point of view and was fin-
ished on time with minimal disruption to the
practice. While it was being completed I went
on a belated honeymoon with my wife to New

March 2011 Volume 5 Number 2 Aesthetic dentistry today 57


Practice profile

Before and after shots of a patient

York. On the day we flew back I received a call VM: You are one of the country’s most
that an alarm was going off at the practice and experienced Invisalign dentists and have
drove down to check it out. A burst water pipe ‘Platinum Elite’ status in the UK. Can you tell
had flooded the practice in four inches of water us more about that?
over three floors and had set the fire alarm off. MW: Invisalign epitomises for me everything I
Welcome home. believe cosmetic dentistry should strive to be.
Improving confidence by improving the ap-
VM: Why did you decide to concentrate on pearance of a smile, while at no time looking
aesthetics? artificial. Clients who come to me for invisalign
MW: As I’ve alluded to it is my belief that car- have already decided they want a treatment in their bed side draw. The Americans are fas-
rying out dentistry without considering aes- option that cannot be seen. That is to say they tidious about retention, because they know the
thetics is ludicrous and has done huge harm have decided they do not want traditional, fixed importance of it.
to our industry and has caused huge distrust. appliances. This allows me to be honest with I have carried out, and by carried out I
An amalgam filling has always looked less like them about my feelings about this technique. I mean finished and monitored, ridiculously
restoration and more like destruction to me. had fixed braces when I was a child and I have complex cases, disfiguring cases. As I only have
But that’s what we were all taught at dental a great smile now, but I also had two years of Invisalign as my tool to straighten teeth it is
school. Function not aesthetics. Aesthetics is being called brace face. the only tool I use. A traditional orthodontist
vain. Cosmetic dentistry is the dark side. Can’t My joke about fixed appliances is this. A who has both fixed appliances and Invisalign
we have both? Many of the brand standards at patient goes to the dentist and says, I need my will err away from Invisalign and lean towards
The Courtyard flip conventional teaching on its teeth straightened because I lack confidence in fixed appliances for the complex cases so may
head. At dental school we were always taught to my smile and my appearance, and the dentist’s never have seen the successes I have.
do the perio and RCT first and the anterior res- cure for their problem is gluing metal wires and As for torquing teeth Invisalign can now
torations last, to ensure the patient came back! brackets to their teeth and making them uglier achieve this with their power ridge technol-
This ultimately meant that the patient has all and more self confident for two years. ogy which quite simply places a fulcrum at the
the time consuming, painful bits of dentistry Traditional orthodontists tend to hate neck of the tooth to apply pressure in a way
first that they cannot see the effects of, and the Invisalign. They say it is unstable. They say that achieves bodily movement. It is this con-
pretty bits last. it can only do mild cases. They say it cannot tinual development that inspires me. If there is
At The Courtyard we do this in reverse. If torque teeth. What isn’t unstable? 50% of the a weak area in their technique then they always
you can spend 30 minutes on a stunning ante- cases we treat are fixed appliance relapses. Half seek to improve on it.
rior composite do you think the patient is going the rest are bruxists whose habits are causing Finally I would say that I am not an or-
to buy into you and your skills? If they see the their teeth to move in the direction of their thodontist. And I say the following line to
difference making their smile more attractive grinding habits. In other words their teeth are my clients; I am a cosmetic dentist who uses
makes do you think they’re going to brush bet- inherently unstable in the environment of their Invisalign as a tool to achieve my goals.
ter? And they’ll come back for the perio too. mouth. Both these groups of people do not need
Also going back to my ‘history’ in art and telling twice about the importance of retention. VM: What is the most satisfying aspect of
design at school I think that the way things I recommend to my clients that they will your work?
look have always been important to me and need to wear a clear retainer every night forever. MW: It may sound obvious or cheesy but it’s
that has given me an advantage in terms of cos- As simple as that. I tell them that if they are the clients. The people I work with. Whether
metic dentistry and the design and appearance looking at a straight white smile on an american it be a check up or a cosmetic case taking two
of our practice. TV show, it is likely that they have a retainer years, they only work with me because they

58 Aesthetic dentistry today March 2011 Volume 5 Number 2


Practice profile

like me, and I only work with them for the same
reason. Similarly, nothing gives me a better kick The evolution of porcelain
than an internal referral. It says not only do I 1. Amalgam invented to fill teeth 28. All porcelain teeth look the same and have
like you enough to come here and pay you for mamelons even though actual real teeth over
2. Amalgam not very attractive at filling front teeth the age of 12 don’t have mamelons.
the unique service you provide, but I am going
to go and tell someone else how good you are 3. People drinking tea out of porcelain cups 29. Some white material called composite appears
until they come here too. That’s the good stuff. in the draws of dentists across the country.
4. Could we make small dinner plates and stick
them on teeth? 30. Dentists are confused and panic.
VM: You have many awards, including the 5. Yes 31. They cannot use it to make teeth look like teeth
recent Private Dentistry Awards. What about as are only good at making teeth look like pegs.
6. Small dinner plates are very fragile and keep
your practice do you think is unique? breaking 32. They try sticking it into holes in back teeth.
MW: On the surface of things we have attracted
7. If we make them thicker they are stronger 33. It takes longer to put into holes in back teeth
attention because of our appearance. Because
and cannot be used underwater, in blood or in
in an era when dental surgeries were either 8. Let’s drill more tooth away so they can be under three minutes so dentists revolt.
thicker
green or blue we went pink and purple. In an
34. Dentists write studies using amalgam and
era when dental practices were named after 9. Still keep breaking rubbish composite proving that amalgam filling
the street they are on or the dentist that works 10. Let’s cook them in an oven on some metal lasts longer.
there, our name doesn’t even tell you we are a because metal is strong 35. Dentists quote this study for next 15 years.
dentist. 11. Dinner plates now thicker
It comes back to innovation which is one of 36. Composite improves at phenomenal rate.
12. Let’s drill a little more tooth away
the awards I was most proud of receiving. I al-
ways tried to deliberately do things differently 13. Teeth keep breaking because metal is so strong 37. Some dentists notice that because composite is
bonded cuspal fracture do not occur.
when I started to create a brand for the prac- 14. Let’s put screws and posts in teeth because they
tice. In all honesty I found this easy because I are metal and metal is strong 38. Amalgam dentists continue placing amalgam
while quoting composite study. Teeth break,
thought so much was wrong with our industry: 15. Roots breaking. Let’s take teeth out. bigger amalgams are placed, more cusps break,
grumpy receptionists, two weeks waiting lists crowns are placed, NHS dentistry thrives.
for an emergency, six weeks waiting for an ap- 16. Can we make dinner plates into bridges so they
stretch over a space? 39. Some dentists use composite to create entire
pointment and no customer service. tooth structure in posterior and anterior
I call it the consultant syndrome. That you 17. Not strong enough. situations. They realise it is not the strength
of the material that is key but the occlusal
are so fortunate to be seeing a dentist or a doc- 18. Let’s use metal. forces subject to the restoration that require
tor with all their knowledge and how busy they management.
19. Have to drill more tooth away.
are that they aren’t going to be nice to you as 40. Some dentists practice the long lost art of
well. The feeling that as a patient you were an 20. Doesn’t matter. making a tooth look like a tooth.
irritation and lucky to be there at all. So that 21. Bridges. Fixed movable bridges. Loads of science 41. They learn how to bond composite to porcelain
belief and the revolt against it underpins many and research papers. More drilling. and realise there are not many instances that
of our brand standards. 22. We hate metal. Metal is ugly. they would need porcelain now.
For example, or the best example: All clients 42. They learn that they can carry out major
23. Zirconia!
get the mobile phone number of their dentist. I aesthetic changes without administering local
24. Zirconia is thicker. More drilling. Who cares. It’s as most aesthetic changes can be achieved in
am often asked, ‘what about the nutters? What the realms of enamel, that is removal of 2mm
only tooth.
if they call you at 2am? of tooth tissue in any direction.
They don’t. They very rarely call you. They 25. White and strong and dinner plates are great.
43. Composite and contouring replaces 90% of all
text you to say thanks. They text you to say 26. 30 years have passed and dentists are really porcelain situations.
they have a referral for you. And in five years good at making teeth look like pegs so they
can stick dinner plates on them. 44. Clients only need one visit for aesthetic and
one has called me with an emergency which I functional changes.
dealt with. Because that’s my job as a private 27. Labs are really good at making pegs look like
teeth that they have seen in a text book 45. Aesthetic cases are more flexible, versatile,
dentist. So ultimately what makes our practice and predictable as the dentist carries out the
because they don’t actually see teeth, only
unique is the belief that it can always be done stone models. work directly in full view of eye line, lip line and
better. Customer service. Cosmetic dentistry. patient feedback.
Conversation. And that we’re not done yet.
Continually raising standards. Always listening
to what our clients tell us. to myself; the challenge starts now. They think need the conviction of your actions to do as
they’ve achieved something by building some- much ‘trading’ as you can to get business mov-
VM: You have created a ‘dream practice’ thing beautiful, but it is making it pay for itself ing. If it’s a restaurant it’s turning tables, in a
– what have been the major hurdles and that is the hard bit. cosmetic dental practice it is beautiful smiles.
obstacles in your path and how much input Okay, it may seem false modesty, as I know Because if you are good at what you do, then
did you have in the design and layout? you need certain skills and taste to design an at- your work speaks for itself and your next cli-
MW: Whenever I watch TV shows where they tractive environment, and I’ll come back to that ent is a result of your previous client. This is a
buy a new restaurant, spend a lot of money in a bit, but the challenge and obstacles come good opportunity to thank Ashley Latter who
renovating it and have a big open day and cel- in the three years after you open your doors, taught me the value of internal referrals and
ebrate by popping champagne I always think not the three months before. That is where you how to increase the chance of getting them.

March 2011 Volume 5 Number 2 Aesthetic dentistry today 59


Practice profile

In terms of my input into the design of the MW: Our commitment to leave the NHS. At His key line was always; Who thinks they are in
practice, the answer is a great deal at every lev- the height of the recession. And our ability to sales? Cue disgusted dentists with their hands
el. From initially communicating my vision to pull it off. In April 2009 we handed back our down. The truth is we are all in sales. If we can-
the architects, to selecting a designer and build- £500,000 NHS contract and moved forward in not communicate the benefits of a treatment
er whose finished work I had seen, to the brand the only way I was ever going to continue to then we will not gain the permission to carry
of The Courtyard which has always tied into the practice dentistry. out that treatment.
colour palette of the practice and surgeries. It would be an understatement to say it was I love sales. Because the key to sales is get-
They always say to create something people not easy. There were massive financial chal- ting the client to genuinely and authentically
want to buy you must be a good consumer. I lenges and we had to lose five members of staff like you and therefore want to work with you.
modelled The Courtyard on bars, restaurants while we built up our sales figures and I had a And you do that by genuinely and authentically
and boutique hotels and I’ve seen a few of them five month old baby boy at home. building rapport with them. In the olden days
in my time. It always comes back to the same That discipline and commitment to our vi- it was called building relationships. It is how
question that I always posed: Why did dental sion defines our team. Their belief in me. Their you build a practice.
practices have to look so bad? The simple an- hard work. And that through it all our focus on
swer is, they don’t. our dentistry never once faltered. VM: What has been your biggest challenge?
MW: Here comes the honesty bit. When you go
VM: What is your opinion on facial aesthetics VM: You are a father of two - how do you against the grain and do the opposite of every-
and does it have a place in the dental balance your work and family time? one else, everyone tells you that you are wrong.
practice? MW: I think all dentists are fortunate in that, When you spend ‘too much’ on refurbishing a
MW: I feel that facial aesthetics does have a practice owner or not it is in theory a ‘9 to 5’ practice. When you go private in a recession.
place in the dental practice. I have been trained job. There are other areas of healthcare that When you make less money as a result of your
in Botox and dermal fillers and I’d say we carry have it much tougher. choices. People tell you you’re wrong. People
out a case a week on average at the practice and That said, of course you have to commit (even your friends) are expecting you to fail.
we are top in google for our area, so in terms of time to achieve what we have in the time we Are waiting for you to fail. That is pretty tough.
volume, it hasn’t changed my life. have. When you have young children you need Because staying true to your convictions
I like Botox. I struggle with fillers. Not tech- to be home before they go to bed or you might when the only person telling you you’re right is
nically but conceptually. I believe that the es- as well be living away from home. So ultimately you, is pretty tough. So that has been my big-
sence of good cosmetic dentistry or good cos- that is and was my goal. You can’t do it every gest challenge.
metic surgery is that you cannot see it. You can’t night. I strive to achieve it two nights a week.
see good cosmetic dentistry and you can’t see But then I make up for it at weekends and VM: What do you think is the future of
good Botox. But I can always see fillers. Even have engineered my diary so I take my two- aesthetic dentistry?
the good stuff is really visible and in my opin- year-old swimming at lunch. So it can be done. MW: I think the future of aesthetic dentistry
ion disfiguring. So that’s not something I want The age old problem is that you are in theo- lies in composite. Let me expand on this
to be focusing my energies on and if anyone ry working so hard for your wife and kids and briefly. We are constantly pushing the enve-
asks for it I’ll refer it on. you don’t want it to cross a line where you’ve lope of what can be artistically and structurally
I feel in general it has a place in the den- done the reverse, and don’t see them or are too achieved with composite and time after time
tal practice particularly for your existing client stressed to be pleasant when you do. we are surprising ourselves. If we imagine for
base. If they are aware of their appearance then a minute that there are dentists out there who
it is likely that it might be on their radar and if VM: Who has been your biggest influence? still believe that amalgam is the best filling for
they want it doing I would rather me do it than MW: Can it be a draw? Chris Barrow and Ashley a tooth.
their hair dresser. Latter. Chris Barrow taught me business and While at our practice we are booking entire
Ashley Latter taught me sales. Both of which days to see a single client for full anterior and
VM: Describe your typical patient. were dirty words in dentistry back then, and posterior aesthetic and functional full mouth
MW: Down to earth. I always remember being maybe still are now. It still amazes me that nei- cases on clients. We feel that like CDs, por-
informed that NHS patients didn’t care what ther subject got a single lecture at dental school celain is a dying breed. Don’t get me wrong,
they got and that private patients were picky when I was there. I still do a lot of porcelain but there are very
and would cause trouble because they were Chris Barrow changed the way me and a few cases when composite could not have done
paying more. My patients pay more. And yes number of other dentists that have gone on to the same job. Given more time I would love to
that does raise their expectations. But they are achieve success thought about dentistry. That describe how the evolution of porcelain over
normal and down to earth. I have little old la- it was about clients not patients. Ultimately for the last 30 years has shaped dentistry and the
dies who have stayed with us from our NHS me it boiled down to the fact that nobody in composite revolution that will follow.
days. Equally I have business owners who ex- our industry seemed to be able to communicate
pect the very best and do not put up with any- with patients. Patients didn’t know what was VM: What are your top tips in maintaining a
thing less. This keeps us on our toes. So I guess happening in their mouths. If we could reclaim successful aesthetic practice?
I would have to thank our clients for keeping us that trust and that relationship then that would MW: Three top tips:
at the top of our game because it is often they be invaluable. I have always held a belief that
who demand it. everyone comes out of dental school with a de- 1.The client comes first.
gree. Everyone can cut a tooth. But less than 5% We are there to serve. That is it. Dental school,
VM: Professionally, what are you most proud can build rapport, loyalty and trust with a pa- the NHS and the consultant syndrome all tried
of? tient. That brings me neatly on to Ashley Latter. to teach us that we weren’t. That we were spe-

60 Aesthetic dentistry today March 2011 Volume 5 Number 2


Practice profile

FACT FILE
Name of practice: Sarah Mann: Treatment coordinator
The Courtyard Rochelle Smith: Reception manager

Emily Kenny: Senior dental nurse and


Practice principal: Floor manager
Marcos White
Sarah Castle: Senior dental nurse and
Invisalign manager
Location: Natalie Daykin: Trainee dental nurse
Huddersfield, West Yorkshire Paminder Kaur: Trainee dental nurse

Patient mix: List of treatments offered:


membership only, fully private, 70% Invisalign
female, 30% male. Implants
Whitening
Veneers dentists to work at the practice and
Brief description of the practice: Botox they are always on some MsC or
The practice is located in a grade II
another so I always make it my focus
listed building in Huddersfield West
Yorkshire. It is spread over three floors
Joining our practice: to pick their brains on what they are
This is the way our menu of services being taught.
and has a cobbled courtyard area with
is listed on our website as we believe I also always make it my focus to
outdoor seating in front.
that a confused customer does not question all current practices and see
The practice was refurbished in
buy. In other words, simplicity is key. if they fit our practice ethos. I am
2007 by the team responsible for the
The ‘veneers’ label in particular is a big always trying to drive the industry
build of every Paul Smith store in the
umbrella term for any porcelain, or any forward and push the envelope on
UK. They brought a specific boutique
direct composite veneer techniques that existing techniques to develop new
quality to the renovation of the
alter the shape, shade or position of a thinking within my practice.
practice more in keeping with retail
tooth.
space than a clinical environment.
They also had a great deal of Practice ethos:
influence in the interior design of our List of big capital equipment/ Motivational dentistry. The concept
signature lounge area for which the technology: that someone with a white smile and
practice has become known. The premises. I purchased the freehold white fillings will always take care of
of three adjoining grade II listed their smile better than someone with
buildings at a cost of £350k. yellow teeth and silver fillings. That is
Staff: to say that the by-product of cosmetic
Marcos White: Practice owner and lead The refurbishment cost £100k. The
surgeries that I added to the practice dentistry is better oral health.
cosmetic dentist
are Adec. We have digital radiography In addition it is my belief that
David Veige: Associate dentist and
throughout and two surgeries are cosmetic dentistry does not mean
implant expert
equipped with intraoral cameras. veneers. It does not mean whitening.
It means that every decision I make
Hygiene therapists:
about treatment considers the
Anne Morrell Postgraduate education: cosmetic effect it will have on the
Kirsty Coxon Paul Tipton Restorative Course in 2007
smile.
Danielle Hinchliffe Cherry picked lectures and courses in all
our core services over the last 10 years.
Anna Sywanyk: Practice manager I always recruit driven and ambitious

cial and they were lucky. We have a unique skill There was a time when a blacksmith would 3. Being the best is the best marketing
and it should be your intention to serve your sharpen your sword for money. The better you can ever have.
clients with that skill for as long as you are in he was the more you would pay. You have a The Courtyard is not the best at everything.
contact with them. Do that and more clients will unique skill. It isn’t just dentistry. It will be a But we are probably the best at something we
come to you to experience the same skills and part of the act of dentistry. It maybe compos- do. And being the best gets you noticed. Even
service. ite. It maybe developing relationships with better. Being the best allows you to tell peo-
your clients. It maybe implants. It may not ple who already come to you that you are the
2. There is nothing purer than the be obvious. Discover it. Develop it. Do more best. And that costs you nothing. And that will
exchange of money for a unique skill. Do of it. Become better at it. Charge more for it. bring you more clients.
not be ashamed of it. Become known for it. A

March 2011 Volume 5 Number 2 Aesthetic dentistry today 61