Exploring the Evolution and Future of Dental Groups in India: An Interview with Dr. Aarti Sharma Kapila

 

Group Dentistry Now recently featured an article on Qatar Investment Authority’s $50 million investment in Clove Dental, a 400-clinic Indian dental group. To understand the Indian dental market more, we sat down with Dr. Aarti Sharma Kapila.

Dr. Kapila is a Co-Founder and Board Member at Osteoskill India Private Ltd., a health-tech start-up, creating 3D printed precision customized medical and dental implants, and Cocoon to Silk Global Partners LLP, a boutique consulting house. Dr. Kapila is a former government dental officer, founding member of India’s largest private dental chain, lab, and mobile clinic,  a recipient of the Dr. Hari Parkash Merit Award for Community Dentistry in Asia-Pacific region by the ICD, and winner of the outstanding leadership in healthcare award at health2.0. Notable among Dr. Kapila’s achievements are creating the trade-marked sterilization and pain management processes and first-of-kind patent-pending real-time clinical quality review process for all clinical procedures during her tenure at Clove Dental.

GDN: As a founding member of Clove Dental in 2011, can you describe the Indian dental market then versus now?

Dr. Kapila: In 2011, when Clove Dental was first established in India, the dental industry was highly fragmented. With 180,000 dentists serving over a billion people through more than 125,000 private and government-run clinics, the sector lacked organization. The prevailing belief was that dental practices operated under the reputation of the owning dentist, making the idea of running a chain of clinics seem improbable. Over 90% of practitioners were concentrated in and around major cities, holding significant sway in procuring dental equipment for hospitals, clinics, and other healthcare facilities.

Job opportunities were limited in both the government and private sectors, leading many dental professionals to establish private practices. However, recent graduates lacked the experience to manage their own practices. Those who joined established practices as observers or associates were often underpaid or required to work without compensation. The overall outlook was challenging.

In 2011, a few major corporate hospitals attempted to initiate dental chains, including the Apollo Group, Manipal Group, Vasan Group, and Narayana Group. Clove Dental was among the first standalone dental chains unaffiliated with tertiary hospitals. All its clinics were owned by the company Star Dental Centre Pvt. Ltd. As of 2023, Apollo Group, Clove Dental, and Sabka Dentist are among the few surviving chains. Each of these companies fully own all its centers. Clove Dental has emerged as the largest dental chain in India, boasting over 400 company-owned clinics.

GDN: It is estimated that the U.S. market is approximately 30% consolidated. How much of the Indian dental market is consolidated?

Dr. Kapila: While competition is minimal due to high demand and limited supply of oral healthcare, 95% of the market is still composed of individual dentists. Some corporate dental groups operate over 100 clinics, while others have fewer than 100.

GDN: What are the trends in the Indian dental market?

Dr. Kapila: International Market Analysis Research and Consulting Group (IMARC) anticipates the oral health and hygiene market to reach US$ 2,586.3 Million by 2028, with a growth rate (CAGR) of 5.3% from 2023 to 2028. The rising awareness of oral health and hygiene primarily fuels this growth. Another contributing factor is the increasing prevalence of dental issues such as cavities, gum disease, and bad breath. Additionally, the ongoing urbanization in India, coupled with higher expenditures on dental services and oral hygiene products, is propelling market expansion. The country’s oral health market is poised for growth due to various factors, including expanding government initiatives, a growing demand for natural and organic oral hygiene products, and the surge in e-commerce retail offering a diverse range of oral health products at affordable prices.

Looking at dentistry trends in 2023-24, some notable developments include:

1. Increased use of advanced dental implants (stock and 3D printed)
2. Customized treatment plans using computer-aided designed and manufactured cosmetic dental solutions.

GDN: Who are the biggest groups in the Indian support market?

Dr. Kapila:

2011:

1. Axiss Dental
2. Narayana Dantalaya
3. Clove Dental
4. Apollo White
5. Denty’s
6. Dentistree
7. Dentzz

2023: 

1. Clove Dental
2. Sabka Dentists
3. Partha Dental
4. Apollo White

Other chains either merged or shut shop or stopped expansion.

GDN: What are the biggest challenges for dental groups operating in India?

Dr. Kapila: The dental healthcare industry faces significant challenges related to a need for more awareness, standardization, quality control, and transparency in pricing. About 12 years ago, there was a notable boom in dental chains, with Vasan Dental Clinics leading in the South and MyDentist (now Sabka Dentist) in the West. Subsequently, Axiss and Clove in the North joined the competition, along with Apollo WHITE Dental, Narayana Dantalaya, Dentistree, and Dentys in the South.

However, before the growth phase could reach a stable tipping point, consolidation, mergers, and closures began to occur. Several chains either declined or faced extinction. Consequently, some clinics opted for mergers, such as Axiss merging with Narayana and Dentys merging with Clove. Meanwhile, some chains halted expansion, and others were forced to close their doors.

Despite receiving funding from the VC/PE community, many of these chains lacked a clear vision and the expertise to create a replicable model. Ambivalent leadership was observed in some cases, while others suffered from poor leadership. The groups that emerged as leaders demonstrated a clear vision, strong leadership, and robust operational and quality standards. These leaders prioritized patient education, treatment transparency, and stringent quality control measures to establish themselves at the forefront of the industry.

GDN: How do Indian policies and procedures affect the dental market?

Dr. Kapila: Government regulations significantly impact the dental business in India. Here are some key points:

1. National Dental Commission Bill, 2023: The Parliament passed this bill to enhance standards in dental healthcare and education. The new regulatory framework aims to ensure optimal dental care for citizens. It involves repealing the Dentists Bill, 1948, establishing the National Dental Commission (NDC) to replace the Dental Council of India (DCI). The law emphasizes technology innovation, industry collaboration, and maintaining an online National Register of licensed dentists and dental assistants.
2. National Oral Health Program: The Indian government established the National Oral Health Program (NOHP) to provide coordinated, affordable, and equitable oral healthcare. Recognizing the prevalence of oral disorders in India, the program seeks to improve the effectiveness and efficiency of oral health care delivery.
3. Insurance and Challenges: Currently, medical insurance in India does not cover oral health unless it results from an unintentional incident. The dental services industry faces obstacles such as increasing privatization, lack of uniformity and transparency, insufficient government oversight, and public attitudes toward oral health.
4. Dental Tourism: The India Dental Market is growing due to the expansion of dental tourism and government initiatives supporting it. The market is projected to grow at a 10% compound annual growth rate from FY 2022 to FY 2027.

These policies and initiatives, focused on professionalism, accountability, and transparency to safeguard the public interest, have the potential to bring significant regulatory changes to dental education.

GDN: What do you predict will happen in the Indian dental market in the next 5-10 years?

Dr. Kapila: The future of dentistry in India appears promising, with current trends expected to persist in the coming years. The ratio of dentists to patients is likely to either remain stable or experience a slight increase, primarily driven by the country’s growing population.

Anticipated in the future is a rise in job opportunities within the dental field, attributed to the expansion of dental clinic chains. These chains employ aggressive marketing strategies and annually hire numerous dental graduates and postgraduates. However, this growth may pose challenges for individuals aspiring to establish their independent practices, as heightened competition becomes a significant factor. Consequently, the dental industry is poised to become more organized and structured in response to these developments.

---