“Sitting in the dentist’s chair, wishing that I wasn’t there.”

Written over a century ago, Robert William’s words in the poem My Dentist are valid. Still. Paying for what is often an invasive, painful procedure doesn’t rank high on the to-do list of most Indians. They’d rather avoid it altogether. A survey done by India’s second largest dental chain, Total Dental Care, showed that Indians, on average, visit a dentist three times. Not a year. Across a lifetime. A majority of them do not floss or brush twice a day.

As such, dentistry has been a hard business to crack in India, even for established names. Almost all those who’ve established dental chains have struggled, with barely any scaling past 100 clinics. For instance, the Apollo White Dental chain—founded in 2002 by Apollo Healthcare—has grown to over 70 dental clinics. Narayana Health’s dental chain—founded in 2008—scaled to 30 clinics in six years, and was then sold to Axiss Dental in 2014. Both Apollo and Narayana are tertiary care hospital chains. Delhi-based Axiss Dental hasn’t found scaling easy either. It is shutting down clinics and has just about 50 functioning clinics at present.

Amidst all of this, one dental chain has slowly but steadily grown to tower over the dentistry landscape—Star Dental, better known by its brand Clove Dental. Where others saw struggle, Star’s founder and CEO Amarinder Singh saw opportunity. “Everyone will need a dentist at some point in their lives,” reasons Singh. “Dentistry is an independent neighbourhood business, and the need in India was simple—dentist jo lootega nahi (not over treat or overcharge). The prevailing lack of trust and confidence gave me an indication to build a brand over time,” he adds.

This idea has since blossomed into India’s largest dental chain, tripling in size over the last two years to 308 clinics spread across 26 cities. Star is now the eighth largest dental chain globally. Its success is a vindication of the potential of India’s dental care services market, estimated by Ken Research (no relation to The Ken) to be growing at double-digit pace. By 2020, Ken Research estimates, it will be worth Rs 14,700 crore ($2 billion).

Star’s biggest competitor is Total, which was founded in 2011, around the same time as its larger rival. The turning point for both chains was January 2017. At the time, Star had about 120 clinics, and Total had 70. But while the former has since grown to over 300 clinics, the latter still numbers around 100, shuttering several clinics as well.

So what accounts for their differing fortunes? Market challenges certainly played a part. In India, a majority of the population either cannot access or afford a dentist. This is made worse because dental care is an entirely out of pocket expense, unlike hospitalisation.

AUTHOR

Ruhi Kandhari

Ruhi writes on the impact of healthcare policies, trends in the healthcare sector and developments on the implementation of Electronic Health Records in India. She has an M. Sc. in Development Studies from the London School of Economics.

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