If rerouting your dreams is a life skill, then Hitesh Tolani learned it early.

In 1983, when he was 1 year old, his parents immigrated to the United States from Sierra Leone. They brought $2,000 with them. They used it to start a clothing store in Columbia, South Carolina. Tolani's father applied for U.S. permanent residency. It was a promising start. But over the next 20 years, there would be many turns for the worse.

Today Tolani, 33, finds himself at the helm of Virtudent, a Boston-based startup aiming to redefine how dental services are delivered. Virtudent sets up a fully staffed "pop up" clinic--chairs, equipment, dentists, hygienists--at your office. Virtudent is in network with four major insurance providers: Delta Dental, Blue Cross Blue Shield, Aetna, and United Healthcare. 

Tolani's gratitude for the journey is profound, given his beginnings. But there's an asterisk to his appreciation. He has a firsthand grasp of a hardheaded truth: The worst news of your life can fuel your dreams. But you have to work relentlessly. And you have to work as if there's no other choice. 

On the verge of deportation.

Tolani was 13 when his father died. The next few years brought more harsh news. Tolani's mother battled breast cancer--with a mastectomy and chemotherapy--while keeping the store afloat. Tolani saw how she continued smiling at customers. It was an early lesson in how to behave--and how to hustle.

In 1997, Tolani's mother learned that her late husband's application for residency could not be passed on to her. Both she and Tolani were illegal, on paper. Though they had a 14-year record of paying taxes and upstanding community participation, the Immigration and Naturalization Service put them into deportation proceedings. 

Meanwhile, Tolani had become a stellar high school student and also worked part-time at a Ramada Inn and a Dairy Queen. Harvard, Columbia, Duke, and Emory accepted him with full scholarships. But he couldn't provide the proof of legal U.S. residency they required. Only one school told him they'd give him a scholarship regardless: Wofford College in Spartanburg, S.C. "I went kicking and screaming," Tolani recalls. "My mother took my letters from the other schools and tore them up and said, 'This is where you're going.'" 

In the summer of 2000, shortly before Tolani began at Wofford, the family had their immigration trial. The judge ordered the family deported. They appealed. Two years later, there was another trial. Again, the judge ruled they had to be deported. Their savings were spent. They had 15 days to leave the country. 

Answered prayers.

Halfway through his Wofford career, Tolani was no longer the solipsistic achiever who "thought the world revolved around himself." He appreciated the school that stuck its neck out for him. And he grasped how his status as a student carried clout. 

He drove to the local newspaper office--the Spartanburg Herald Journal--and told them his story. Within the week, there was an outpouring of support for the family--even in a post-9/11 climate that was hardly immigrant-friendly. Tolani says more than 35,000 people contacted senators and congressmen on his family's behalf. Eventually, Senator Strom Thurmond submitted a private relief bill for the family. Shortly after graduating from Wofford, Tolani got a phone call from Senator Fritz Hollings's office, confirming that he and his mother were now legal U.S. residents.

Tolani went on to pursue dental training at the University of Pennsylvania. While there, he was an adviser to undergrads, living on campus with them. The undergrads became his first patients. After they left school, many of them still wanted Tolani to be their dentist. He began researching how telehealth--services delivered remotely via phone or communications technologies--could be applied to dentistry. 

Tolani wanted not only to help his young patients but also to pay forward all the kindnesses done for him and his family. He felt fortunate to be a healthy, educated citizen of the U.S. He wondered how he could take everything he was learning about dentistry--and use it to help those less fortunate.  

An entrepreneurial solution.

A 2012 investigation on Frontline called "Dollars and Dentists" highlighted the roughly 49 million Americans with no access to dental care. It also shone a light on how dental practices overcharge patients. Tolani, fascinated by the investigation, recognized that telehealth could potentially address these problems. "Here I am using teledentistry with my friends, and I see that the market for this is actually more broad," he says. Meanwhile, he was completing his dental training at various stops, with residencies at the University of Washington, Stony Brook, and Tufts.

Today, in addition to running Virtudent, he lectures at both Tufts and Harvard Dental Schools. The three-employee Virtudent team (not including its staff of dentists and hygienists) started selling its services this July. While the company has not yet raised any venture capital, it has garnered some prominent Boston-based cash and recognition. After honing Virtudent's business model at the Harvard Innovation Lab last year, Virtudent won $3,500 (third place) in the Tufts 100K New Ventures Competition and $15,000 (runner-up) in the Harvard President's Challenge. This year, it won $50,000 as a finalist in the MassChallenge, a contest run by a state-sponsored accelerator.

For employers, Virtudent means less employee time is lost to dental visits--an inconvenience that the American Dental Association estimates costs businesses 164 million work hours annually. So far, clients include WeWork and Maxwell Health. The clinic provides basic preventative services--cleanings, X-rays, dental sealants, and fluoride varnish application. And it refers patients who need further treatment to practitioners in nearby offices.

Here's how it works, in a nutshell: Virtudent visits your office and sets up the clinic. If you want an appointment, you book it through Virtudent's online patient portal. Your insurance covers all of the services. You can also pay out of pocket. An exam--conducted by the dentists and hygienists on the Virtudent staff-- usually takes 45 minutes. The cost, Tolani says, is comparable to what you'd pay for the same services if you visited a dentist's office. 

Within 48 hours of your exam, you'll get an email telling you your diagnosis is ready. Then you can login to the patient portal to view your dental health records, including X-rays, intra-oral images, and notes. So far, Virtudent is operating only in Massachusetts, since regulatory requirements are state by state. But Tolani and his team are exploring which states to enter next. And while all aspects of teledentistry are on the table for the startup, Virtudent wants to perfect its delivery and execution of the pop-up office clinics before jumping into long-distance care. 

Far from the self-important young man he was, Tolani finds it hard to discuss Virtudent without invoking the institutions--and the 35,000 supporters--who helped him get where he is. Given its current capabilities, Virtudent is a long way away from fulfilling Tolani's deepest dreams: helping millions worldwide with no access to dental care. But his life experiences have taught him that you have to start somewhere. If you do the best you can, if you show yourself to be an upstanding member of a local community--well, you never know how many supporters will be out there for you, when you most need them. 

Published on: Nov 16, 2015