By Dr John Barclay | DRJB Smile Clinic, Ruabon, North Wales Membership plans get a vague reputation. People assume they're a way of locking patients into a subscription that doesn't really save them anything. Here's the actual structure of ours, the actual numbers, and an honest answer to whether it's worth it — including the cases where it isn't. How the Plan Works We have five tiers — A through E — and which one you're on depends on the complexity of your dental history, not your budget. Tier A is for patients with straightforward dentition: a tooth or two with minor fillings, nothing more. Tier E is for patients with extensive existing work — most teeth have had some form of treatment, and the level of ongoing monitoring and care required is correspondingly higher. Tier A starts at around £28 a month. Tier E sits closer to £50 a month. The bands in between scale according to how much your mouth needs looking after. This isn't arbitrary. A mouth with extensive restorative history needs more frequent monitoring, more imaging, and a higher likelihood of needing further treatment over time. The plan price reflects that reality rather than charging everyone the same regardless of need. You Need to Be Dentally Fit to Join This catches some people by surprise, so it's worth saying plainly: the plan isn't a way of paying down a backlog of existing problems. Before joining, outstanding issues need to be sorted first — decay treated, anything urgent addressed. The plan covers what happens from that point forward, not what's already going wrong when you sign up. That said, we're realistic about this. If your list of outstanding work is long, we won't simply turn you away. We'll talk through a sensible plan to get you dentally fit first, then bring you onto membership once you're there. We're human, and the aim is to make this work for real people with real histories — not to set an impossible bar. What's Actually Included Every plan includes two full examinations a year and between two and four hygiene visits a year, depending on your band — patients with more complex needs or higher periodontal risk get more frequent hygiene support built in. Beyond that, the plan covers any new restorative treatment that's clinically necessary — fillings, crowns, anything required to treat disease and protect the health of a tooth. If a problem emerges that needs fixing to keep a tooth healthy, that treatment is included. What's not included is anything cosmetic — anything that's a want rather than a clinical need. Whitening, veneers, composite bonding for aesthetic reasons sit outside the plan because they're elective. Implants are also not included — they're a significant procedure in their own right, priced and discussed separately. One more detail: if a crown or restoration requires lab work, you pay only the actual lab cost. The clinical treatment, fitting, and ongoing care around it are already covered. We don't mark up lab fees or treat them as a separate profit line. What It Would Cost Without the Plan Here's where the actual numbers matter. Paid individually: an examination is £64. A hygiene visit is £77 for a standard 20-minute session, or £105 for a more thorough 30-minute session — the length depends on what your gums need, not what you choose. A simple filling is £150, a more complex one £300. A crown is £650 for a molar in monolithic zirconia, or £900 for a front tooth in emax with a multi-layered shade match. Root canal treatment is £500 for a front tooth, £700 for a molar. Now put that against the plan. A Tier A patient — minimal ongoing need, two exams and two hygiene visits a year, nothing else required — pays roughly £282 a year for that care paid individually. The plan, at around £28 a month, comes to £336 a year. In a year where genuinely nothing else happens, the plan costs slightly more than paying as you go. That's the honest answer, and we'd rather you knew it than discover it later. But the moment anything restorative is needed — even one simple filling at £150 — the comparison flips. £282 plus that filling is £432. The plan, unchanged at £336, has already saved you money. For a patient on a higher tier — more hygiene visits built in because the need is greater, and a higher likelihood of restorative work coming up during the year — the plan wins by a wider margin almost every time. A single crown alone, at £650 to £900, costs more than a year of membership on most tiers. Two exams, several hygiene visits, and one piece of restorative work in a year without a plan can easily exceed £1,000. The same year, on a plan, costs exactly what you're already paying monthly. Nothing more. Why We Structure It This Way The honest answer: dental need isn't equal across patients, and a flat fee for everyone would either overcharge people with simple mouths or undercharge people with complex ones. The tiered structure means you're paying for what your mouth actually needs — not subsidising someone else's, and not being subsidised either. If You're Considering Joining The right tier for you depends on an assessment — we won't guess, and we won't put you on a higher tier than your history justifies. If you've got existing work that needs sorting first, we'll find a sensible way through that too. 📞 01978 823490 📧 infodesk@drjbsmileclinic.co.uk Start Your Smile Journey → References & Further Reading 1. British Dental Association. Dental plans and patient charges: a guide for patients. BDA, 2022. → General context on how private dental membership plans are structured across UK practice. 2. Office for National Statistics. Private healthcare spending trends, UK. ONS, 2023. → Broader context for predictable-cost healthcare models and patient budgeting behaviour. 3. Public Health England / OHID. Delivering Better Oral Health: An Evidence-Based Toolkit for Prevention. 4th ed. OHID, 2021. → Underpins the rationale for tiered recall frequency based on individual periodontal and caries risk. Related Reading Your Subscriptions Probably Cost More Than You Think. So Does Skipping the Dentist. NHS Dentistry in Wales Is in Crisis. Here's What That Actually Means for You. Looking for a Dentist in North Wales? Here's What to Actually Look For.

By Dr John Barclay | GDC No. 210844 | DRJB Smile Clinic, Ruabon, North Wales A patient asked me recently why I'd suggested emax for her centrals when the composite I'd placed five years earlier still looked, in her words, "perfectly fine." It was a fair question. Here's the answer I gave her, and the framework behind it. Composite and Emax Aren't Competing for the Same Job The mistake — made by patients and, occasionally, by dentists under pressure to close a treatment plan — is treating composite and emax as two versions of the same decision. They're not. They solve different problems on different timelines, and conflating them leads to either over-treatment or under-treatment. Composite is additive, reversible, repairable, and immediate. Emax is a definitive restoration requiring tooth preparation, a lab process, and a longer-term commitment. The question is never simply "which is better" — it's "which is right for this tooth, at this point in its life, for this patient." The Conversation at the Original Consultation This is where the real work happens, and it happens before any material touches the tooth. I tell every composite patient — explicitly, not implied — that the result, however good, has a lifespan. Ferrule effect, compressive strength relative to a definitive restoration, and the practical limits of a material that sits on the surface rather than replacing it: all of this gets said plainly, at the time of the original treatment, not retrospectively when something chips. The line I use: you will likely outlive this composite. Not because it's a bad result — it might be excellent. But everything has a lifespan, and I'd rather you know that now than be surprised later. That conversation is informed consent in the truest sense. The patient who hears it and chooses composite anyway has made an informed choice. The patient who hears it and still feels surprised five years later when a margin discolours has not been let down by the material. They've been let down by a consultation that didn't say this clearly enough. When I Suggest the Upgrade Not at a fixed interval. Not because composite has an expiry date stamped on it. I suggest the conversation again when one or more of the following appears: repeated fracture at the same site, margin staining that polishing can't resolve, occlusal load that's clearly exceeding what the material was designed for, or simply enough time has passed that the patient's own priorities may have shifted. The patient who declines the upgrade and is happy is not a treatment failure. She's exercising an informed choice I gave her the information to make. The composite doing exactly what composite does — ageing, eventually needing replacement — is not a complication. It's the material behaving as expected. What Changes the Decision Number of previous repairs matters more than time elapsed. One chip in five years is a different conversation to three chips in eighteen months. Location matters — an incisal edge under heavy function is a different risk profile to a lingual surface. Patient expectation matters — someone who wants permanence and minimal maintenance is a different conversation to someone who's comfortable with periodic touch-ups. When I do move to emax, the brief is precise: match the existing dentition, not an idealised shade. A centrals-only emax case in a patient with composite-bonded laterals and canines needs the new restoration to sit invisibly within work that's already aged in the mouth. My nurses are better at this than I am — shade matching is a skill in its own right, and I defer to it. The Point of Saying All of This Out Loud Fair warning of consequences limits painful surprises when something eventually fails or breaks. That's not pessimism. It's the difference between a patient who comes back to you when something happens, and a patient who goes elsewhere to complain about you. If you've got a composite rehab case that's approaching this conversation — or one that isn't there yet but you want a second opinion on the long-term plan — I'm happy to be part of it. North Wales, Cheshire, Shropshire and beyond. 📧 infodesk@drjbsmileclinic.co.uk References & Further Reading 1. Magne P, Belser U. Bonded Porcelain Restorations in the Anterior Dentition. Quintessence Publishing, 2002. → Foundational reference for ferrule effect and biomechanical considerations in definitive anterior restoration planning. 2. Heintze SD, Rousson V. Clinical effectiveness of direct class I and class II restorations — a meta-analysis. Journal of Adhesive Dentistry, 2012. → Evidence base for composite longevity and failure modes informing the upgrade decision framework. 3. Demarco FF et al. Longevity of posterior composite restorations: not only a matter of materials. Dental Materials, 2012. → Supports the multifactorial view of restoration failure beyond material alone. 4. General Dental Council. Standards for the Dental Team — Principle 3: Obtain valid consent. GDC, 2013 (updated 2019). → Underpins the informed consent framework for the original consultation conversation. Related Reading Cases I Take On That Others Don't. Three Appointments. No Surprises. What Composite Bonding at DRJB Actually Involves. Composite Bonding vs Veneers — Which Is Right for You? How Long Does Composite Bonding Last? Porcelain Veneers Explained