Crooked business: Indonesia’s amateur dentists ply dubious trade

Unlicensed ‘dental workers’ are popular among lower-income Indonesians who can’t afford qualified practitioners.

Unlicensed 'dental workers', known as 'tukang gigi', are common in Indonesia [Courtesy of Rifqie Al Haris]

Ubud, Indonesia – Putri Wulandari will never forget stepping into a roadside shophouse in Indonesia’s capital Jakarta to get braces for her teeth.

The room was small and dingy, with a worn-out recliner chair perched next to a dirty bathroom. The only person to greet her was a man in a t-shirt.

Wulandari does not know if the equipment he used was sterilised, but he did not wear a surgical mask or latex gloves.

“It was very fast. He only asked me to choose what colours I wanted and then immediately went for my teeth,” Wulandari, 22, told Al Jazeera.

For Wulandari, who had wanted braces since high school, a qualified dentist was out of the question.

“If I went to a dentist or a clinic, the cost would have been somewhere around five million rupiahs ($348),” she said. “The dental worker charged me only 200,000 rupiahs ($14).”

Putri Wulandari
Putri Wulandari spent about $14 for braces at an unlicensed dental practitioner [Courtesy of Putri Wulandari]

“Dental workers”, known as “tukang gigi”, are commonly found tucked away in alleys and sidestreets in Indonesia’s cities, often advertising their services with lurid signs featuring pearly whites and blood-red gums.

They offer dental work at rock bottom prices, targeting people with lower incomes. Most practitioners are believed to be self-taught and lack any formal qualification, although some claim to have received non-medical training from dental worker unions.

Their trade is legal in Indonesia, albeit subject to certain regulations. According to Ministry of Health regulations, practitioners must register their practice and obtain a “dental worker permit” from the local health authority. They are also only legally allowed to make or fit dentures and are strictly prohibited from performing other dental procedures.

The reality, however, is far less regulated. While there are no official figures, cheap, unregistered dental practitioners are practically ubiquitous in Indonesia. Those looking for a winning smile at a bargain need only to look to the thousands of Instagram and Facebook accounts advertising services ranging from basic tooth extractions to cosmetic procedures.

For Wulandari, the visit to an unlicensed dental worker left her with crooked, misaligned teeth.

“Before this, my teeth were fine, just a slight overbite, that’s all,” she said. “But a year after he put the braces on me, my teeth began to shift places, and I was in a lot of pain. I went back a few times, but he kept telling me that it’s all normal.”

Wulandari said she had no option but to take matters into her own hands.

“I couldn’t take it any more. I decided to take out the braces, at home, by myself, with a nail clipper,” she said.

Wulandari, whose husband works as a motorcycle taxi driver, thought about reporting the practice to the police, only to learn he had packed up shop and left.

Rifqie Al Haris
Al Haris has spent five years warning of the dangers of unlicensed dentistry in Indonesia [Courtesy of Rifqie Al Haris]

Rifqie Al Haris has spent the last five years dealing with numerous tales of dental disasters similar to Wulandari’s.

In 2016, Al Haris, a 37-year-old dentist by profession, started a social media project called KorTuGi, short for “Korban Tukang Gigi”, or “Dental Worker’s Victims” in Indonesian.

On Instagram, Facebook, and YouTube, he posts cautionary images and videos of botched dental work carried out by underqualified practitioners. The visuals are not for the faint-hearted.

“The idea is to raise public awareness about dental health and the danger of unlicensed dentistry,” Al Haris told Al Jazeera. “Some people still think that going to a dentist or a dental clinic is only for when you have a terrible toothache. It is also seen as something expensive, which is why many turn to informal dental workers when they have dental needs.”

“In some cases I found, it ended in death,” he added.

On social media, Al Haris has shared more than 900 cases of botched dental procedures. He said demand for certain procedures has surged in recent years, likely driven by social media stars and celebrities.

“In the past, these cases tended to revolve around failed dentures. But within the last few years, we have seen more illegal practitioners tapping into the cosmetic dental demand, advertising aesthetic treatments such as braces, veneers, teeth whitening, or buck teeth, and targeting the young,” he said. “They even hired social media influencers to promote their services.”

Many of those who fall victim to unscrupulous practitioners see dental work as a marker of status and affluence that would otherwise only be available at exorbitant cost, Al Haris said.

“It’s no longer medical need, it’s fashion,” he said. “Some people are willing to do whatever it takes to chase that status symbol.”

‘Perfect smile’

Meanwhile, Julia, one of the thousands of Indonesians offering dental treatment without a license, insists that everybody, including the have-nots, deserves a perfect smile.

After opening a beauty salon that focused on eyelash extensions and nail art, she last year expanded her services to include dental work such as veneers and braces.

“Some of my clients are students, but most are workers for the nightlife industries, like bars or nightclubs. Appearance, like having a beautiful smile, is important. But it needs to be affordable,” Julia, 28, told Al Jazeera, speaking on condition of anonymity.

Despite having no formal dentistry training, Julia, who majored in accounting at vocational school, insists that a short workshop she took gave her all the knowledge needed to get to work.

And she claims she has yet to receive a single customer complaint.

“It was a full-on eight-hour course, covering everything from braces and veneer installations to working with all the equipment. The course also provided each student with a model to practice with,” Julia said, declining to give detail about the course except to say it was held at a large beauty salon in Jakarta.

“I am aware that what I’m doing is illegal. But there is a lot of demand, and many other salons also offer similar services. I don’t think beauty treatments like braces or veneers will damage the teeth, but in the future, who knows. I may stop doing this if I receive complaints,” she said.

“So far, though, no bad luck.”

Unlicensed "dental workers" in Indonesia
Most ‘dental workers’ in Indonesia don’t have a licence and are believed to be self-taught [Courtesy of Rifqie Al Haris]

Although Indonesia has universal healthcare, it does not cover the cost of orthodontic and cosmetic procedures. For the majority of Indonesians, this means such treatments remain out of reach.

This fact, according to Al Haris, makes public education about dental care all the more pressing.

“People need to understand that they are risking their lives by going to illegal practitioners. It is not worth it,” he said.

“I think, at this point, public education is key. These practices are so rampant that it will be difficult to banish them all at once. But we can help the youth make more informed choices about their dental health. When people stop going to those places, those illegal practices will no longer flourish.”

Source: Al Jazeera