New Delhi: Dental technology start-up toothsi, which counts prominent celebrities such as cricketer Virat Kohli and actor Anushka Sharma among its brand ambassadors, describes itself as “India’s first and largest at-home smile makeover service provider using ground-breaking Clear Aligner technology to make teeth straightening simple and affordable”.
Now the company, along with similar service providers, is under fire from the Dental Council of India (DCI), which has said that these firms violate several norms of the Dentists Act, 1948, and the revised Dentists (Code of Ethics) Regulations, 2014, ThePrint has learnt.
Among the violations listed by the DCI is employing “untrained and unregistered personnel to carry out dental services”.
In a directive issued to state dental councils last week, the DCI, which regulates dental professionals and dental education in the country, said it had come to its notice that certain companies such as toothsi are “engaging in the provision of dental treatments, teeth scanning and aligner services directly to patients at their homes”.
“These services are reportedly being carried out by individuals who are not registered as dentists with the respective state dental councils,” the DCI’s order states. ThePrint has a copy of the letter.
Launched in 2018, toothsi merged with cosmetic solutions provider MakeO — which also has the skincare brand skinnsi under its umbrella — in 2022. On its website, toothsi calls itself “India’s leading clear aligner brand”, which offers “at-home scans, smile makeovers to solve issues such as teeth gap and teeth alignment, oral hygiene and teeth whitening products”.
But experts ThePrint spoke with pointed out that these services belong to a branch of dentistry called orthodontics that is related to diagnosing and treating bad bites or malocclusion (misalignment of teeth). Common orthodontic treatments include braces, clear aligners and retainers.
The dental regulator has also written that, according to the provisions of the Dentists Act, only individuals duly registered with state dental councils are authorised to practice dentistry.
Also, the (dental) code of ethics emphasises the necessity of maintaining professional standards and protecting patient safety, which are jeopardised by unregistered practitioners, the DCI has said.
It has instructed the state councils to issue immediate “cease and desist orders” to the companies and individuals found to be violating the provisions of the Dentists Act, 1948, and initiate appropriate legal action against those found to be in violation of the norms.
There is no record that any action has been initiated in the past against these companies either by the DCI or the state councils.
In its directive, the regulator has said that a detailed report of the actions taken and outcomes achieved should be sent to it within 30 days, while also instructing states to raise public awareness regarding the risks associated with receiving dental treatments from unregistered practitioners.
The DCI has said that it emphasises the importance of “adhering to the legal and ethical frameworks that govern the practice of dentistry in India” and added that “the protection of patient health and the maintenance of professional standards are of utmost priority”.
The move was welcomed by some independent dental health experts.
“I have been hearing about companies like toothsi which, riding on mega advertising campaigns, trap gullible people and in many cases, use salesmen to offer dental health services. This is totally unacceptable,” said Dr Mahesh Verma, prosthodontist and vice-chancellor of Guru Gobind Singh Indraprastha University and a former vice president of the DCI.
Dr Priyank Rai, professor of orthodontics at Maulana Azad Institute of Dental Sciences, told ThePrint that companies like toothsi provide orthodontics treatments but without employing specialists.
“Within dentistry, too, orthodontics is a specialisation but these firms do not rope in specialists — there are marketing personnel who are given some very basic training and sent to client’s homes to perform services,” Rai said.
ThePrint reached toothsi over email for its comments on the DCI’s directive but did not get a response. This report will be updated if and when a reply is received.
Growing menace of ‘unethical dental services’
A senior member of the Indian Dental Association (IDA), the largest network of dentists in the country, who did not wish to be named, said that start-ups offering at-home dental services have mushroomed over the last few years.
Mumbai-based Doctor365 is one such company. On its website, the start-up calls itself “an emerging and fastest-growing healthcare service provider in India, focusing on critical care services at home by providing a complete solution in terms of setting up an ICU at home”.
Among its services are “home dental care” which include extraction, teeth removal to teeth cleaning and whitening, night guard, dentures and orthodontic treatments.
The IDA member who spoke with ThePrint said that to perform such functions in a non-clinical setting may even be dangerous.
“Procedures like tooth extraction, for example, are like minor surgeries that can be done only in certain settings with specified infrastructure and by a trained dentist. This kind of service is a clear violation of existing laws,” she said.
Yet, as she underlined, such service providers have sprung up in almost all major cities.
Dr Arry’s Mediclinic, a start-up which offers dental services in Delhi-NCR and Jaipur, among other medical facilities, is another such example.
“We believe in providing all our patients with safe, easy, affordable and accurate services by sending an expert dentist at home, which not only ensures safety but also ease of access for patients for whom travel is an unnecessary risk and hassle and may endanger their life,” the company says on its website.
ThePrint sent queries to these companies through email on the directive by the DCI but did not get a response. This report will be updated if and when a reply is received.
The DCI had previously issued a public notice in 2021 flagging private companies offering in-home (dental) services to patients “bypassing the professional expertise of dentists and functioning on aggressive marketing in violation of the provisions of Clinical Establishments (Registration and Regulation) Act, 2010” — a central law to regulate private healthcare providers and dental service norms.
A year later, in 2022, another public notice was issued by the DCI against the running of “unauthorised dental courses by unauthorised authorities/institutions”.
This notice said that some “unscrupulous” firms had been awarding dental qualifications without any prior and valid permission from the DCI or state councils.
Verma said, “In fact, this was because the DCI had been alerted that many companies are just awarding some certification to marketing personnel who then pose as dentists and perform dental procedures at the homes of the people who opt for their services.”
According to the IDA member quoted earlier, there is no record that any action was initiated against these companies either by the DCI or the state councils.
“Issuing advisories and public notices is one thing, but what is being done to contain these service providers when they are clearly carrying out their business in violation of norms?” she asked.
(Edited by Nida Fatima Siddiqui)
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