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
background, qualifications and postgraduate
training?
MW: Let me paint a picture. At school I was
good at art and design and also sciences. I
wanted to go into a design career but my dad
told me it was an overcrowded marketplace and
I would struggle to get a job. He suggested I use
my aptitude in sciences to pursue a vocational
degree. I decided on dentistry.
My aptitude in science turned out to be
somewhat relative as when it came to A levels
I was the weakest in Maths and Chemistry and
my predicted grades reflected this meaning I
only got two offers for dental school, Leeds and
Glasgow.
I preferred Leeds and put that on my UCAS
form and pulled out the grades required surpris-
ing my secondary school teachers. University
was fantastic fun and I met many inspirational
tutors and lecturers but never shone in particu-
lar sitting retakes in first and second year.
If we now skip forward to my VT year in
Nottingham and a 99.9% NHS practice where
everything was amalgam, dentures, extractions
and plaque. I was earning very well but became
quickly jaded and decided to take a year out
to go travelling. I had intended to pick apples
and serve in bars while away but quickly found
out how little they pay you to pick apples and
had a change of heart! So six months into the
trip we arrived in Sydney and I had sorted the
necessary paperwork en route to work in Oz. I
secured three jobs in the Central Coast that in-
volved living in the dentists’ houses while they
were on holiday, driving their cars and swim-
ming in their pools. And doing their fillings.
White fillings. This showed me another side to
dentistry that differed massively from what I
had seen and showed me that big white fillings
worked.
When I returned to the UK I took an as-
sociate job at ‘The Courtyard Dental Centre’ in
Huddersfield. Alan Neve showed me an empty
room with his bicycle parked in it and told me
that there would be a surgery in there within
three months and that I would be building an
NHS list from scratch. I knew my dentistry was
a little rusty from lying on beaches so his en-
ergy and enthusiasm for dentistry clinched the
deal for me and convinced me this was a place
I could learn.
A short two years later Alan told me that he
and his wife were emigrating to New Zealand
and did I want to buy the now two surgery
NHS practice from him. I said yes and much of
the rest is history.
VM: When and why did you become a practice
owner?
MW: On 5th August 2006 I signed for my
practice. I remember vividly the song that was
playing on my IPod that morning as I walked
to work from the train station. I remember the
nerves in my stomach. I remember being aware
that my life would change forever from that day
forth.
I became a practice owner by accident. By
default. I became a practice owner because my
boss was emigrating and I wasn’t prepared to
have a new guy come in and be my boss. That
was as far as my thinking went on the matter.
VM: How did you build your business?
MW: In the early days of owning the practice I
put in a bid to increase our NHS contract from
£384k to £500k, which was successful. We
took on more patients, built another surgery
and grew in that way. Over time I was carry-
ing out more and more private treatments on
my NHS patients and it became apparent that I
would be able to attract a private list that would
fill my time.
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
that an alarm was going off at the practice and
drove down to check it out. A burst water pipe
had flooded the practice in four inches of water
over three floors and had set the fire alarm off.
Welcome home.
VM: Why did you decide to concentrate on
aesthetics?
MW: As I’ve alluded to it is my belief that car-
rying out dentistry without considering aes-
thetics is ludicrous and has done huge harm
to our industry and has caused huge distrust.
An amalgam filling has always looked less like
restoration and more like destruction to me.
But that’s what we were all taught at dental
school. Function not aesthetics. Aesthetics is
vain. Cosmetic dentistry is the dark side. Can’t
we have both? Many of the brand standards at
The Courtyard flip conventional teaching on its
head. At dental school we were always taught to
do the perio and RCT first and the anterior res-
torations last, to ensure the patient came back!
This ultimately meant that the patient has all
the time consuming, painful bits of dentistry
first that they cannot see the effects of, and the
pretty bits last.
At The Courtyard we do this in reverse. If
you can spend 30 minutes on a stunning ante-
rior composite do you think the patient is going
to buy into you and your skills? If they see the
difference making their smile more attractive
makes do you think they’re going to brush bet-
ter? And they’ll come back for the perio too.
Also going back to my ‘history’ in art and
design at school I think that the way things
look have always been important to me and
that has given me an advantage in terms of cos-
metic dentistry and the design and appearance
of our practice.
58 Aesthetic dentistry today March 2011 Volume 5 Number 2
VM: You are one of the country’s most
experienced Invisalign dentists and have
‘Platinum Elite’ status in the UK. Can you tell
us more about that?
MW: Invisalign epitomises for me everything I
believe cosmetic dentistry should strive to be.
Improving confidence by improving the ap-
pearance of a smile, while at no time looking
artificial. Clients who come to me for invisalign
have already decided they want a treatment
option that cannot be seen. That is to say they
have decided they do not want traditional, fixed
appliances. This allows me to be honest with
them about my feelings about this technique. I
had fixed braces when I was a child and I have
a great smile now, but I also had two years of
being called brace face.
My joke about fixed appliances is this. A
patient goes to the dentist and says, I need my
teeth straightened because I lack confidence in
my smile and my appearance, and the dentist’s
cure for their problem is gluing metal wires and
brackets to their teeth and making them uglier
and more self confident for two years.
Traditional orthodontists tend to hate
Invisalign. They say it is unstable. They say
it can only do mild cases. They say it cannot
torque teeth. What isn’t unstable? 50% of the
cases we treat are fixed appliance relapses. Half
the rest are bruxists whose habits are causing
their teeth to move in the direction of their
grinding habits. In other words their teeth are
inherently unstable in the environment of their
mouth. Both these groups of people do not need
telling twice about the importance of retention.
I recommend to my clients that they will
need to wear a clear retainer every night forever.
As simple as that. I tell them that if they are
looking at a straight white smile on an american
TV show, it is likely that they have a retainer
in their bed side draw. The Americans are fas-
tidious about retention, because they know the
importance of it.
I have carried out, and by carried out I
mean finished and monitored, ridiculously
complex cases, disfiguring cases. As I only have
Invisalign as my tool to straighten teeth it is
the only tool I use. A traditional orthodontist
who has both fixed appliances and Invisalign
will err away from Invisalign and lean towards
fixed appliances for the complex cases so may
never have seen the successes I have.
As for torquing teeth Invisalign can now
achieve this with their power ridge technol-
ogy which quite simply places a fulcrum at the
neck of the tooth to apply pressure in a way
that achieves bodily movement. It is this con-
tinual development that inspires me. If there is
a weak area in their technique then they always
seek to improve on it.
Finally I would say that I am not an or-
thodontist. And I say the following line to
my clients; I am a cosmetic dentist who uses
Invisalign as a tool to achieve my goals.
VM: What is the most satisfying aspect of
your work?
MW: It may sound obvious or cheesy but it’s
the clients. The people I work with. Whether
it be a check up or a cosmetic case taking two
years, they only work with me because they

like me, and I only work with them for the same
reason. Similarly, nothing gives me a better kick
than an internal referral. It says not only do I
like you enough to come here and pay you for
the unique service you provide, but I am going
to go and tell someone else how good you are
until they come here too. That’s the good stuff.
VM: You have many awards, including the
recent Private Dentistry Awards. What about
your practice do you think is unique?
MW: On the surface of things we have attracted
attention because of our appearance. Because
in an era when dental surgeries were either
green or blue we went pink and purple. In an
era when dental practices were named after
the street they are on or the dentist that works
there, our name doesn’t even tell you we are a
dentist.
It comes back to innovation which is one of
the awards I was most proud of receiving. I al-
ways tried to deliberately do things differently
when I started to create a brand for the prac-
tice. In all honesty I found this easy because I
thought so much was wrong with our industry:
grumpy receptionists, two weeks waiting lists
for an emergency, six weeks waiting for an ap-
pointment and no customer service.
I call it the consultant syndrome. That you
are so fortunate to be seeing a dentist or a doc-
tor with all their knowledge and how busy they
are that they aren’t going to be nice to you as
well. The feeling that as a patient you were an
irritation and lucky to be there at all. So that
belief and the revolt against it underpins many
of our brand standards.
For example, or the best example: All clients
get the mobile phone number of their dentist. I
am often asked, ‘what about the nutters? What
if they call you at 2am?
They don’t. They very rarely call you. They
text you to say thanks. They text you to say
they have a referral for you. And in five years
one has called me with an emergency which I
dealt with. Because that’s my job as a private
dentist. So ultimately what makes our practice
unique is the belief that it can always be done
better. Customer service. Cosmetic dentistry.
Conversation. And that we’re not done yet.
Continually raising standards. Always listening
to what our clients tell us.
VM: You have created a ‘dream practice’
– what have been the major hurdles and
obstacles in your path and how much input
did you have in the design and layout?
MW: Whenever I watch TV shows where they
buy a new restaurant, spend a lot of money
renovating it and have a big open day and cel-
ebrate by popping champagne I always think
March 2011 Volume 5 Number 2 Aesthetic dentistry today 59
The evolution of porcelain
1. Amalgam invented to fill teeth
2. Amalgam not very attractive at filling front teeth
3. People drinking tea out of porcelain cups
4. Could we make small dinner plates and stick
them on teeth?
5. Yes
6. Small dinner plates are very fragile and keep
breaking
7. If we make them thicker they are stronger
8. Let’s drill more tooth away so they can be
thicker
9. Still keep breaking
10. Let’s cook them in an oven on some metal
because metal is strong
11. Dinner plates now thicker
12. Let’s drill a little more tooth away
13. Teeth keep breaking because metal is so strong
14. Let’s put screws and posts in teeth because they
are metal and metal is strong
15. Roots breaking. Let’s take teeth out.
16. Can we make dinner plates into bridges so they
stretch over a space?
17. Not strong enough.
18. Let’s use metal.
19. Have to drill more tooth away.
20. Doesn’t matter.
21. Bridges. Fixed movable bridges. Loads of science
and research papers. More drilling.
22. We hate metal. Metal is ugly.
23. Zirconia!
24. Zirconia is thicker. More drilling. Who cares. It’s
only tooth.
25. White and strong and dinner plates are great.
26. 30 years have passed and dentists are really
good at making teeth look like pegs so they
can stick dinner plates on them.
27. Labs are really good at making pegs look like
teeth that they have seen in a text book
because they don’t actually see teeth, only
stone models.
to myself; the challenge starts now. They think
they’ve achieved something by building some-
thing beautiful, but it is making it pay for itself
that is the hard bit.
Okay, it may seem false modesty, as I know
you need certain skills and taste to design an at-
tractive environment, and I’ll come back to that
in a bit, but the challenge and obstacles come
in the three years after you open your doors,
not the three months before. That is where you
Practice profile
28. All porcelain teeth look the same and have
mamelons even though actual real teeth over
the age of 12 don’t have mamelons.
29. Some white material called composite appears
in the draws of dentists across the country.
30. Dentists are confused and panic.
31. They cannot use it to make teeth look like teeth
as are only good at making teeth look like pegs.
32. They try sticking it into holes in back teeth.
33. It takes longer to put into holes in back teeth
and cannot be used underwater, in blood or in
under three minutes so dentists revolt.
34. Dentists write studies using amalgam and
rubbish composite proving that amalgam filling
lasts longer.
35. Dentists quote this study for next 15 years.
36. Composite improves at phenomenal rate.
37. Some dentists notice that because composite is
bonded cuspal fracture do not occur.
38. Amalgam dentists continue placing amalgam
while quoting composite study. Teeth break,
bigger amalgams are placed, more cusps break,
crowns are placed, NHS dentistry thrives.
39. Some dentists use composite to create entire
tooth structure in posterior and anterior
situations. They realise it is not the strength
of the material that is key but the occlusal
forces subject to the restoration that require
management.
40. Some dentists practice the long lost art of
making a tooth look like a tooth.
41. They learn how to bond composite to porcelain
and realise there are not many instances that
they would need porcelain now.
42. They learn that they can carry out major
aesthetic changes without administering local
as most aesthetic changes can be achieved in
the realms of enamel, that is removal of 2mm
of tooth tissue in any direction.
43. Composite and contouring replaces 90% of all
porcelain situations.
44. Clients only need one visit for aesthetic and
functional changes.
45. Aesthetic cases are more flexible, versatile,
and predictable as the dentist carries out the
work directly in full view of eye line, lip line and
patient feedback.
need the conviction of your actions to do as
much ‘trading’ as you can to get business mov-
ing. If it’s a restaurant it’s turning tables, in a
cosmetic dental practice it is beautiful smiles.
Because if you are good at what you do, then
your work speaks for itself and your next cli-
ent is a result of your previous client. This is a
good opportunity to thank Ashley Latter who
taught me the value of internal referrals and
how to increase the chance of getting them.
Practice profile
In terms of my input into the design of the
practice, the answer is a great deal at every lev-
el. From initially communicating my vision to
the architects, to selecting a designer and build-
er whose finished work I had seen, to the brand
of The Courtyard which has always tied into the
colour palette of the practice and surgeries.
They always say to create something people
want to buy you must be a good consumer. I
modelled The Courtyard on bars, restaurants
and boutique hotels and I’ve seen a few of them
in my time. It always comes back to the same
question that I always posed: Why did dental
practices have to look so bad? The simple an-
swer is, they don’t.
VM: What is your opinion on facial aesthetics
and does it have a place in the dental
practice?
MW: I feel that facial aesthetics does have a
place in the dental practice. I have been trained
in Botox and dermal fillers and I’d say we carry
out a case a week on average at the practice and
we are top in google for our area, so in terms of
volume, it hasn’t changed my life.
I like Botox. I struggle with fillers. Not tech-
nically but conceptually. I believe that the es-
sence of good cosmetic dentistry or good cos-
metic surgery is that you cannot see it. You can’t
see good cosmetic dentistry and you can’t see
good Botox. But I can always see fillers. Even
the good stuff is really visible and in my opin-
ion disfiguring. So that’s not something I want
to be focusing my energies on and if anyone
asks for it I’ll refer it on.
I feel in general it has a place in the den-
tal practice particularly for your existing client
base. If they are aware of their appearance then
it is likely that it might be on their radar and if
they want it doing I would rather me do it than
their hair dresser.
VM: Describe your typical patient.
MW: Down to earth. I always remember being
informed that NHS patients didn’t care what
they got and that private patients were picky
and would cause trouble because they were
paying more. My patients pay more. And yes
that does raise their expectations. But they are
normal and down to earth. I have little old la-
dies who have stayed with us from our NHS
days. Equally I have business owners who ex-
pect the very best and do not put up with any-
thing less. This keeps us on our toes. So I guess
I would have to thank our clients for keeping us
at the top of our game because it is often they
who demand it.
VM: Professionally, what are you most proud
of?
60 Aesthetic dentistry today March 2011 Volume 5 Number 2
MW: Our commitment to leave the NHS. At
the height of the recession. And our ability to
pull it off. In April 2009 we handed back our
£500,000 NHS contract and moved forward in
the only way I was ever going to continue to
practice dentistry.
It would be an understatement to say it was
not easy. There were massive financial chal-
lenges and we had to lose five members of staff
while we built up our sales figures and I had a
five month old baby boy at home.
That discipline and commitment to our vi-
sion defines our team. Their belief in me. Their
hard work. And that through it all our focus on
our dentistry never once faltered.
VM: You are a father of two - how do you
balance your work and family time?
MW: I think all dentists are fortunate in that,
practice owner or not it is in theory a ‘9 to 5’
job. There are other areas of healthcare that
have it much tougher.
That said, of course you have to commit
time to achieve what we have in the time we
have. When you have young children you need
to be home before they go to bed or you might
as well be living away from home. So ultimately
that is and was my goal. You can’t do it every
night. I strive to achieve it two nights a week.
But then I make up for it at weekends and
have engineered my diary so I take my two-
year-old swimming at lunch. So it can be done.
The age old problem is that you are in theo-
ry working so hard for your wife and kids and
you don’t want it to cross a line where you’ve
done the reverse, and don’t see them or are too
stressed to be pleasant when you do.
VM: Who has been your biggest influence?
MW: Can it be a draw? Chris Barrow and Ashley
Latter. Chris Barrow taught me business and
Ashley Latter taught me sales. Both of which
were dirty words in dentistry back then, and
maybe still are now. It still amazes me that nei-
ther subject got a single lecture at dental school
when I was there.
Chris Barrow changed the way me and a
number of other dentists that have gone on to
achieve success thought about dentistry. That
it was about clients not patients. Ultimately for
me it boiled down to the fact that nobody in
our industry seemed to be able to communicate
with patients. Patients didn’t know what was
happening in their mouths. If we could reclaim
that trust and that relationship then that would
be invaluable. I have always held a belief that
everyone comes out of dental school with a de-
gree. Everyone can cut a tooth. But less than 5%
can build rapport, loyalty and trust with a pa-
tient. That brings me neatly on to Ashley Latter.
His key line was always; Who thinks they are in
sales? Cue disgusted dentists with their hands
down. The truth is we are all in sales. If we can-
not communicate the benefits of a treatment
then we will not gain the permission to carry
out that treatment.
I love sales. Because the key to sales is get-
ting the client to genuinely and authentically
like you and therefore want to work with you.
And you do that by genuinely and authentically
building rapport with them. In the olden days
it was called building relationships. It is how
you build a practice.
VM: What has been your biggest challenge?
MW: Here comes the honesty bit. When you go
against the grain and do the opposite of every-
one else, everyone tells you that you are wrong.
When you spend ‘too much’ on refurbishing a
practice. When you go private in a recession.
When you make less money as a result of your
choices. People tell you you’re wrong. People
(even your friends) are expecting you to fail.
Are waiting for you to fail. That is pretty tough.
Because staying true to your convictions
when the only person telling you you’re right is
you, is pretty tough. So that has been my big-
gest challenge.
VM: What do you think is the future of
aesthetic dentistry?
MW: I think the future of aesthetic dentistry
lies in composite. Let me expand on this
briefly. We are constantly pushing the enve-
lope of what can be artistically and structurally
achieved with composite and time after time
we are surprising ourselves. If we imagine for
a minute that there are dentists out there who
still believe that amalgam is the best filling for
a tooth.
While at our practice we are booking entire
days to see a single client for full anterior and
posterior aesthetic and functional full mouth
cases on clients. We feel that like CDs, por-
celain is a dying breed. Don’t get me wrong,
I still do a lot of porcelain but there are very
few cases when composite could not have done
the same job. Given more time I would love to
describe how the evolution of porcelain over
the last 30 years has shaped dentistry and the
composite revolution that will follow.
VM: What are your top tips in maintaining a
successful aesthetic practice?
MW: Three top tips:
1.The client comes first.
We are there to serve. That is it. Dental school,
the NHS and the consultant syndrome all tried
to teach us that we weren’t. That we were spe-
 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%
female, 30% male.
Brief description of the practice:
The practice is located in a grade II
listed building in Huddersfield West
Yorkshire. It is spread over three floors
and has a cobbled courtyard area with
outdoor seating in front.
The practice was refurbished in
2007 by the team responsible for the
build of every Paul Smith store in the
UK. They brought a specific boutique
quality to the renovation of the
practice more in keeping with retail
space than a clinical environment.
They also had a great deal of
influence in the interior design of our
signature lounge area for which the
practice has become known.
Staff:
Marcos White: Practice owner and lead The refurbishment cost £100k. The
cosmetic dentist
David Veige: Associate dentist and
implant expert
Hygiene therapists:
Anne Morrell
Kirsty Coxon
Danielle Hinchliffe
Anna Sywanyk: Practice manager
Invisalign
Implants
Whitening
Veneers
Botox
Joining our practice:
This is the way our menu of services
is listed on our website as we believe
that a confused customer does not
buy. In other words, simplicity is key.
The ‘veneers’ label in particular is a big
umbrella term for any porcelain, or any
direct composite veneer techniques that
alter the shape, shade or position of a
tooth.
List of big capital equipment/
technology:
The premises. I purchased the freehold
of three adjoining grade II listed
buildings at a cost of £350k.
surgeries that I added to the practice
are Adec. We have digital radiography
throughout and two surgeries are
equipped with intraoral cameras.
Postgraduate education:
Paul Tipton Restorative Course in 2007
Cherry picked lectures and courses in all
our core services over the last 10 years.
I always recruit driven and ambitious
dentists to work at the practice and
they are always on some MsC or
another so I always make it my focus
to pick their brains on what they are
being taught.
I also always make it my focus to
question all current practices and see
if they fit our practice ethos. I am
always trying to drive the industry
forward and push the envelope on
existing techniques to develop new
thinking within my practice.
Practice ethos:
Motivational dentistry. The concept
that someone with a white smile and
white fillings will always take care of
their smile better than someone with
yellow teeth and silver fillings. That is
to say that the by-product of cosmetic
dentistry is better oral health.
In addition it is my belief that
cosmetic dentistry does not mean
veneers. It does not mean whitening.
It means that every decision I make
about treatment considers the
cosmetic effect it will have on the
smile.

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

March 2011 Volume 5 Number 2 Aesthetic dentistry today 61