Mention a visit to the dentist and chances are that most people around the world will grimace and shudder. But they would probably go for their annual checkups as part of their health care regime, at least in the developed countries. For the average Indian, however, formal dental care is nowhere on the calendar. Dental hygiene comprises brushing once a day or, at best, twice and, typically, a visit to the dentist happens only if there is unbearable pain.
M.P. Devaiah and Vivek Madappa, cofounders of MobiDent, a Bangalore-based dental-care startup, see this as an opportunity waiting to be extracted. The World Health Organization recommends annual dental checkups for adults and bi-annual ones for children, but people tend to give them a miss primarily for three reasons: They are expensive, time consuming and painful. There is also very low awareness. Devaiah and Madappa believe that removing these barriers can make a radical difference to how Indians approach dental care. “Our aim is to provide inexpensive and world-class dental care at a person’s doorstep — anywhere and anytime,” say the duo.
MobiDent’s unique proposition is its “dental clinic in a suitcase.” This comprises instruments and equipment required for basic procedures such as deep cleaning, plaque and tartar removal and polishing, and a portable dental chair designed by Devaiah. The founders call it a “taxi model” since it can be easily taken anywhere in a car or a cab.
A more advanced version with additional instruments and equipment like x-ray machines and air compressors, consumables for different treatments and so on is transported in company-owned vans to the patient’s location. Unlike in conventional dentistry where setting up a clinic typically costs upwards of Rs.8 lakh ($12,000), the MobiDent taxi model costs only Rs.75,000 ($1,125). The van model costs between Rs.1.5 lakh ($2,250) and Rs.3 lakh ($4,500).
The founders zeroed in on this low-cost, portable model by questioning the basic premise of how dental care is delivered. Their research showed that most dental treatment can be done in a non-clinic setting; people need to go to a clinic primarily for surgeries or complex procedures. “Our model does away with the high infrastructure and operational costs of traditional clinics which make dental care very expensive and allows us to price our treatments around 20% lower than regular dentists,” says Madappa.
MobiDent also differs from traditional dentistry in its strong focus on preventive care. According to Devaiah, preventive and maintenance dental care reduces the chances of serious problems for any individual by 80% to 90%. This in turn automatically reduces the amount they would need to shell out for dental treatment.
In line with this thinking, MobiDent has devised special annual packages for home service. It offers a mouth spa for a family of six at Rs.2,750 ($41), for a couple at Rs.1,750 ($26) and for individuals at Rs.900 ($13.50). This includes two home visits in a year for deep cleaning, plaque and tartar removal and polishing. In addition, the patients get a dental health report, unlimited tele-consultations and 10% off on any further treatment. The MobiDent founders believe that if they can offer a mouth spa “at a price similar to what general physicians typically charge for a consultation, then people will stop thinking of dental treatment as expensive.”
The MobiDent approach does away with another cost element. A typical dental chair costs anywhere from around Rs.1 lakh ($1,500) to Rs.6 lakh ($9,000) and upwards. The MobiDent chair, however, costs only Rs.6,000 ($90). Devaiah points out that while some functions of high-priced dental chairs are needed for surgeries, many other features are there simply for their “feel good” factor. Since billing is highest in surgeries, everyone wants these surgical chairs. But for more than 80% of the treatments, basic recliner chairs with a few add-ons are adequate.
Other strategic moves by the founders include building a large team of dentists and thereby bringing economies of scale; setting up the MobiDent Academy of Dental Excellence to train their dentists in anywhere, anytime treatment; and leveraging digital technologies to manage logistics and delivery.
“Through its innovative delivery model and by removing the bells and whistles, MobiDent has unlocked a huge potential.” –Amit Karna
Ujwal Kayande, professor of marketing and director of analytics at the Melbourne Business School in Australia, believes that MobiDent has the “potential to disrupt” dental care in India. Kayande, who is an advisor to the startup, says: “MobiDent’s big innovation is its attempt to overcome the passive resistance to dental care by going to customers instead of waiting for them to come. Its strategy of preventive services rather than reacting to a problem is also refreshingly different.”
“Through its innovative delivery model and removing the bells and whistles, MobiDent has unlocked a huge potential. The number of people who can afford dental care [under this model] will go up exponentially,” says Amit Karna, professor of strategic management at the Indian Institute of Management Ahmedabad (IIMA) and chairperson of IIMA’s Center for Innovation, Incubation and Entrepreneurship (CIIE). This center promotes Indian startups which have the potential for disrupting existing industries and creating mass impact. In September 2016, impressed with MobiDent’s proposition, CIIE invested Rs.20 lakh ($30,000) in it.
The founders, who began with Rs.10 lakh ($15,000) of personal funds in July 2014, have other believers, too. In July 2015, they raised Rs1.25 crore ($187,500) for a 12.5% stake from New York-based DanGold Investment Corp and a few angel investors. In December last year, they raised $250,000 pre-series ‘A’ funding again from DanGold.
The Last Mile
The cofounders make for an interesting combination of business acumen and dental expertise. Madappa is a serial entrepreneur with successful ventures across diverse areas such as digital automation, education and hospitality. One of his firms, HummingBird, provides travel and accommodation services to large corporations. Madappa has previously worked at senior positions with leading consumer goods firms like Tata Global Beverages and Marico, and has built successful brands.
Devaiah is a dentist with over 25 of years of experience. In 2010, bitten by an experimenting and entrepreneurial bug, he bought a chassis and steering, and designed and built a mobile dental bus for himself. “Given the traffic congestion in Bangalore, many of my patients used to ask if I could treat them at their homes. That led me to think that there could be a market for mobile dentistry,” explains Devaiah.
It took eight months of perseverance and an investment of Rs.40 lakh ($60,000) before he got his mobile dental bus up and running in July 2011. Over the next two years he built a client base of around 70 corporations and held dental camps at their premises with a team of two dentists. “Initially it took a lot of convincing to bring the corporations on board. I must have written thousands of letters of which 20 replied, and then I had to make repeated visits explaining my concept. But once we started our service, it grew by word of mouth,” recalls Devaiah.
As he looked to expand his mobile practice, one of the biggest things he learned was that he had yet to solve the “last mile” problem. His bus could go only into the parking lots of companies; what he needed was a dental setup that could go inside the offices. He then designed a lightweight, portable dental chair. “Around 85% of dental problems can be treated with a simple inclined chair, a spittoon and sophisticated, hand-held titanium tipped scalers,” says Devaiah.
In 2014, he got Madappa on board and they set up MobiDent with three dentists. Since then, the team has grown to over 50 members comprising a few management executives, around 35 dentists and 15 support staff. The company provides dental services at offices, hospitals and homes. In the corporate segment, MobiDent holds dental camps – typically spread over two to four days — at the premises of its clients. In the hospital segment, it runs the dental outpatient departments of the hospitals concerned on a profit sharing arrangement. In the home segment, the dentists visit the patients at their homes. The startup also offers free treatment through charitable organizations and holds awareness camps in schools and residential areas.
Building on Home Care
While currently the corporate and hospital divisions bring in the bulk of the revenues, the target is to make home service the mainstay. Madappa and Devaiah believe that once people are exposed to MobiDent in schools, offices and hospitals, they will be open to having its services in the comfort and convenience of their homes.
“Home dental care is a very different ballgame and requires very different skills. We introduced this in October last year only after we were confident that we had all the elements in place,” says Madappa. The biggest difference in delivering home care is the mindset of the dentists and the way they approach the patients, says Devaiah. “Dentists, like all doctors, are used to being problem solvers. Patients come to them with a problem, and they solve it for them. But in our model, the dentist is more of a care giver and a service provider. This requires a completely different orientation.”
“Around 85% of dental problems can be treated with a simple inclined chair, spittoon and sophisticated, hand-held titanium tipped scalers.” –M.P. Devaiah
This is where MobiDent’s curriculum, quality standards, systems and processes play an important role, say the founders. The company typically hires dentists with two to three years of experience. The academy then trains them in the latest techniques and also in delivery protocol and soft and social skills required for home service. These include skills around communication and presentation, creating an emotional connect with patients and building empathy.
“Delivering a consistent and standardized experience is an integral part of any brand experience. And it is especially important in health care which is all about trust,” notes Kayande.
Even as it is looking to attract customers, MobiDent wants to make itself an attractive alternative for dentists. The Indian dental care segment is largely unorganized with over 90% being stand-alone clinics; in recent years, a few dental chains like Alliance Dental Care, Star Dental and MyDentist have cropped up.
India has around 30,000 dental graduates every year. Most of them end up working for small salaries of around Rs.5,000 ($75) to Rs.7,000 ($105) per month, with senior dentists in their clinics. Some try to set up their own clinics after a few years. But this is an expensive affair; it typically costs anywhere from Rs.8 lakh ($12,000) to Rs.15 lakh ($22,500) to set up a clinic and then another five years or more before it is well established. What MobiDent promises is a starting salary upwards of Rs.20,000 ($300) per month, training in the latest dental care technologies, exposure to a wide range of patients, leadership training and a strong career path.
So far, the MobiDent team has served more than 50,000 patients across 400 companies, 21 hospitals and 350 homes. Its corporate clients include marquee names such as General Electric, Tata Consultancy Services and HSBC Bank. In hospitals, its partnerships include well-known chains such as Columbia Asia, Sahyadri Hospitals and Rainbow Hospitals. In addition to Bangalore, MobiDent is now present in Mysore, Pune and Ahmedabad, and has a presence in Nairobi with Columbia Africa Healthcare.
The Credibility Factor
Kayande sees these relationships as important ways for MobiDent to create awareness and visibility and to increase its reach. The partnerships with hospitals have an additional advantage of building credibility, he adds. “Providing any affordable service can sometimes raise concerns about its quality. By collaborating with well-established hospitals, MobiDent can allay any such perceptions.”
For hospitals, too, outsourcing their dental services is a smart business move, says Jitin Doshi, cofounder of edental, the online dental store of Doshi Marketing Corporation, a leading Mumbai-based dealer and distributor of dental care products. Pointing out that dental care is not a core offering of general hospitals, Doshi says: “By outsourcing it to a specialist provider, hospitals can ensure quality service without any additional investments in space, equipment or manpower.”
“Most people believe that brushing daily is more than adequate for oral care. It is this passive resistance that needs to be overcome.” –Ujwal Kayande
Madhur Varma, CEO of Sahyadri Hospitals, agrees. “Typically, dental setups require a lot of dedicated space. That is not the case with MobiDent. And because their dentists are mobile, the specialists can be made available as and when required and in whichever location.” Sahyadri Hospitals is one of the largest health care chains in the western state of Maharashtra and has nine hospitals across three cities. Currently, it has outsourced dental services to MobiDent in five of its premises. Varma plans to extend this arrangement to the remaining locations over the next few months.
MobiDent has had a good run so far. According to the founders, revenues have increased from Rs.24 lakh ($36,000) in financial year 2015 to Rs.1.2 crore ($180,000) in 2016. They expect to close the current year (FY 2017) at Rs.2.25 crore ($337,000). The company has been cash positive from the first month.
Encouraged by their journey up to now, Madappa and Devaiah have chalked out an ambitious growth plan. Over the next three years, they are looking to hire over 3,000 dentists and be present in the top 50 cities across the country.
MobiDent’s ambitions, however, have inherent challenges. Take the hiring of dentists. As the company starts recruiting in large numbers, it plans to take on more fresh graduates. But the majority of dental graduates in India are not market ready and will require extensive training in basic dentistry. Then there is the issue of managing their egos, schooling them to work in a non-clinic environment and molding their mindset to that of a service provider. “The doctor-patient relationship needs to be replaced by a doctor-customer relationship in order to create the right customer experience,” says Chaitanya Deshpande, a Mumbai-based angel investor of MobiDent. As the company scales, the backend logistics of inventory management, scheduling and delivery will need to be extremely well oiled, adds Ajay Bhandoola, an angel investor based in Dubai. “In health care the execution needs to be faultless every time. There can be no element of adhocism,” he cautions.
Building a strong brand that embodies trust is another key factor for success, adds Kayande. But the biggest challenge, he thinks, will be in changing the attitudes and mindset of people. “Making dental care accessible and affordable is very important, but most people believe that brushing daily is more than adequate for oral care. It is this passive resistance that needs to be overcome,” he says.