Caizen Dental and Facial Cosmetics

In this article Dr Kevin Magee BDS FDS RCS describes the transformation of a derelict off-license near his home on the Isle of Sheppey, Kent, into a luxurious private dental practice, offering general and cosmetic dentistry while focusing on dental implantology and adult orthodontics.

History

Having graduated from University College Cork in July 1990 with a Bachelor of Dental Surgery (BDS), my first associate post was at the mixed practice of Mr John Flynn (RIP) at 19 The Broadway, Sheerness, in August 1990. There was no VT scheme then so it was in at the deep end. Mr Flynn was the best mentor/tutor a new graduate could have wished for. He was courteous, soft-spoken and patient with novice dentists. Merely two years later I bought my first dental practice in Gillingham, Kent. This was primarily an NHS based practice, which – with my wife Paula – developed into a mixed NHS/private practice within months of taking over, doing a Denplan conversion at the same time. 

In 1999 I decided to study for the Fellowship in Dental Surgery at the Royal College of Surgeons London. Having passed the Primary FDS examination on the first attempt, I secured a part-time 2-year training post at the Medway Maritime Hospital, as Honorary Clinical Assistant to Mr Kenneth Lavery MBBS, FDS, FRCS, Consultant Maxillofacial Surgeon, and Mr Paul Scanlon (RIP), Consultant Orthodontist, who mentored me personally in all aspects of orthodontics. Following this, I obtained a position as Senior House Officer in Oral and Maxillofacial Surgery at Kent & Canterbury Hospital, under the leadership of Mr John Storrs, Mr Chris Hendy and Mr Norman Bradley, all Consultant Maxillofacial surgeons, and obtained the diploma of FDS RCS in London in 2002. 

During this time as SHO, I developed the full range of skills in surgical dentistry, as well as oral and maxillofacial surgery, including sedation techniques and operating on patients under general anaesthesia. It was also during this time that I realised I could put these newly acquired skills to full use by incorporating dental implants into general dental practice. Already equipped with the dental techniques required to restore dental implants, I could now do all stages of implantology within my own practice. 

In 2002, the Gillingham practice was sold to allow me to concentrate on dental implantology, which until August 2015, I had been carrying out either as an associate or as a freelance peripatetic dentist in a number of practices. This included practices in Kent and Essex, providing general and cosmetic dentistry, adult orthodontics, periodontal (gum) surgery, bone grafting, dental reconstruction, and facial rejuvenation treatments.

A Squat Practice

By the beginning of 2015, I felt it was time that I had my own practice once more, and carefully considered all the options. By then, I knew I wanted to concentrate on private adult dentistry, having had enough of the UDA nonsense and “clawbacks”. Therefore, purchasing a mixed private/NHS practice was out of the question. Buying an entirely private practice would entail paying for “goodwill”, which could turn out to be not-so-good. I wrote a business plan, detailing the practice I had in mind. I realised that to have the type of practice that I wanted would mean starting from scratch as a squat. My wife Paula, who is a Nursing Matron on the Isle of Sheppey, pointed out that the derelict off-license at Halfway, Sheerness had a “To Let” sign on the window and that perhaps I should enquire about taking it on. We approached the landlord, who was keen to have a dental practice as his tenant on a long-term lease. Although the ground floor was vacant, the first floor was a 2-bedroom flat, occupied by a family who fortunately were about to relocate anyway. 

In March 2015, pre-planning application advice was sought from the Council, who were most helpful in offering guidance on how to make a Change of Use application that would likely meet with approval. Armed with this information I contacted Clark Dental’s Matt Rowlingson and a local builder, Jeff Hamilton, to arrange a meeting at the premises, in order to get an idea of the building work to be undertaken and the costs involved. Matt drew up preliminary plans with corresponding costs for equipment, fixtures and fittings, while Jeff gave me some approximate costings for the building works. Matt put me in touch with Ray Cox of Medifinance to discuss funding options for the project. It had been made clear to me early on that developing a squat practice, with no NHS element and essentially no client base, would be too much risk for any high street bank to entertain. 

On the strength of the well-written business plan and my clinical experience, Ray managed to secure initial funds from Funding Circle to allow the building work to begin in June – a month before submitting the Planning Application for Change of Use. Repayment of loans begins a month after receiving the funds, which meant continuing to work as an associate for the foreseeable future. Matt expertly managed the project, while Jeff worked tirelessly to an exceptionally high standard of workmanship. In September, planning consent was granted, while extra funding was required for unexpected building complications, Shawbrook Bank, again through Medifinance, funded all the surgery and decontamination equipment supplied by Clark Dental, while I deferred to my wife’s better taste in interior design and colour schemes! Our website was created by the award-winning team at Dental Media: my thanks to Dave and Vanessa for their professionalism, friendliness and patience towards me.

With financial pressures mounting I was keen to open to clients in November, but we still had to obtain CQC registration, the applications having been submitted in mid-September. I instructed Jeff to stop work on the first floor (designated as office space) to wholly concentrate on finishing the ground floor dental practice. I met with the very helpful Mick Smithson, the CQC inspector, on the 1st of October. He was happy with the plans and the layout of the practice with its designated decontamination room. We would just need certification from the Building Control Inspector before CQC registration. This certification took another 2 months, before we were finally allowed to accept paying clients in mid-January 2016.

The Present and Future 

Our client base continues to grow slowly but surely through word of mouth recommendations. Initially, our clients were patients who had followed me from practice to practice when I worked as an associate at various locations in Kent and Essex. We don’t have a practice reception simply because they can be quite intimidating for anxious clients. Instead, we have two small but cosy client lounges (Paddi Lund’s idea). I personally do all the appointment bookings and, therefore, have complete control over my working day and the clients I wish to treat. Because our staff at present comprises myself and a trainee dental nurse, we cannot have people walking in off the street while I’m operating. As such, we have a locked door policy, with clients being seen by invitation. Otherwise I am certain that we would be inundated with patients looking for NHS dentistry, which we don’t provide.

We offer a full range of dental procedures including simple and complex dental implantology, advanced restorative and reconstructive dentistry, endodontics, periodontology, and adult orthodontics. In addition, we are now carrying out quite a lot of facial rejuvenation with Botox, dermal fillers, chemical peels and non-surgical facial thread-lifting.

With the expert carpentry and general building skills of my friend Dave Stevenson, we have recently completed the refurbishment of the first floor of the practice. It is now ready for the first cohort of delegates on our newly developed short day- and year-long certificate courses to be held in our conference room from July 2018 (www.caizentraining.co.uk).
As I have finally resigned from NHS dentistry and from the eight-year associate position, I can now concentrate on developing Caizen Dental and Facial Cosmetics (www.caizen.co.uk). There is still a long way to go, but as the word “Caizen” suggests, we’ll get there with continuing small steps of improvement.