Dentists are trained to think of business as a slightly embarrassing necessity — something that happens at the front desk while the real work happens in the surgery. I have come to believe the opposite: the business model is a clinical instrument. It decides how many minutes you can give a patient, which implant systems and materials you can afford to stand behind, whether your nurses are calm or burned out, whether follow-up is a promise or a cost centre. The difference between good and bad dentistry is often not clinical at all — it is the business model behind it, and the patient can feel it within five minutes of walking in.
When I founded Maida Smiles in 2019, in Little Venice, London had no shortage of dental clinics. What it lacked, I felt, was clinics designed around the patient's intelligence. We published our prices online when that was still unusual in private dentistry, because a patient who has to phone three times and sit through a sales consultation to learn what a dental implant costs has already been told exactly what the clinic thinks of them. We wrote treatment plans in plain English. We built in time to say no to treatment that was not needed — the most profitable sentence in the long run, though no spreadsheet will show it in year one.
What the bet returned
The bet worked, and faster than I projected. Within the first year the clinic was named Most Advanced Dental Clinic at the Greater London Enterprise Awards and shortlisted twice at the Private Dentistry Awards; the interior, built around a wall of five hundred handmade ceramic discs, took a Surface Design Award. I am proud of the trophies, but more telling is the quieter data: our patients stayed. They reviewed us in the hundreds, unprompted. They sent their parents, then their children. In implant dentistry — where a full-arch patient may trust you with a five-figure decision and twenty years of chewing — retention is not a marketing metric. It is the clinical audit that matters most.
Growth, deliberately slow
Paddington Smiles opened in 2025 — a second clinic near Paddington station, fully private, built on the same principles rather than a diluted franchise of them. Same planning discipline, same materials, same refusal to sell treatment; different postcode. Smila, our clear-aligner brand, exists for a related reason: aligner treatment was increasingly being sold in the UK as a commodity — scanned by one person, planned by an algorithm, reviewed by nobody — and we believed teeth that move deserve the same clinical seriousness as teeth that are replaced. Each venture answers the same question: where is dentistry underestimating its patients?
The real difference between volume dentistry and private dentistry is not clinical. It is the business model — and the patient can feel it in the first five minutes.
People ask what the five-year plan is. It is unglamorous: keep the standard. Scale is only interesting if the thousandth patient gets the same honesty, the same planning discipline, and the same follow-up as the first — otherwise growth is just dilution with better branding. That is harder than opening locations. It is also the entire point.