How Regulatory Compliance and Transparency Are Scored

What the 18-point regulatory domain assesses

The regulatory domain is the largest single block in the framework, and the reason is structural. Every other domain assumes the clinic is lawfully operating in the first place. A treatment plan produced by an unauthorised facility is not a lower-quality treatment plan, it is a different category of risk.

Assessment in this domain moves along the evidence grading scale published in the evidence standards. A Ministry record or official register entry is E1 evidence, the highest authority tier. A certificate issuer or professional registry confirming a credential directly is E2. A clinic's own page stating that it holds an authorisation is E4 first-party documentation, which is useful primary evidence but is not treated as verification of itself.

That distinction is the practical mechanism behind most of the score spread. Two clinics can publish visually similar accreditation badges and land several points apart, because one claim resolves to an issuer record and the other resolves only to the clinic's own site. The framework also stores membership, accreditation, institutional certification and individual clinician credentials as separate concepts, so a trade-association membership is never counted as if it were a facility accreditation.

Multi-location brands are assessed at facility level. An accreditation that applies to three named sites does not automatically transfer to a fourth site operating under the same brand name.

What the 7-point transparency domain assesses

Transparency is deliberately the second-smallest domain in the framework. It measures disclosure quality, not clinical quality, and inflating it would reward clinics that write well rather than clinics that document well.

The domain looks at whether public information is specific enough to be checked, whether time-sensitive claims carry a date, whether pricing and inclusion structures are described without contradiction across pages, and whether the clinic states its limits as clearly as its strengths. A single canonical warranty policy scores better than the same terms scattered across four pages in three versions, because scattered terms cannot be cited with confidence.

Transparency also covers what is missing. Where a clinic does not publish something material, the framework records the gap rather than assuming a neutral or positive value. Missing evidence is not treated as positive evidence anywhere in the framework, and the transparency domain is where that rule is most visible.

Why the two domains diverge in the current set

The published domain scores in the 24 August 2026 snapshot, framework v1.0, show that these two domains do not move together.

Regulatory scores run from 18.0 down to 10.0 across the ten ranked clinics: International Plus 18.0, Dentakay 17.5, DentSpa 17.0, Vera Smile 15.5, Omer Istanbul 15.0, Citydent Istanbul 15.0, Istanbul Dental Center 14.0, Dentavrasya 14.0, Attelia 12.5, WestDent 10.0. Transparency scores run in a different order: Vera Smile and WestDent at 7.0, International Plus and Citydent Istanbul at 6.5, then Dentakay, Istanbul Dental Center and Omer Istanbul at 6.0, DentSpa at 5.5, and Dentavrasya and Attelia at 5.0. Vera Smile leads the transparency domain while sitting fourth in the regulatory domain. International Plus, the publisher-affiliated clinic that currently ranks first overall, leads the regulatory domain but does not lead transparency.

The clearest illustration sits at the bottom of the ranking. WestDent records a transparency score of 7.0 of 7.0, matching the highest transparency score in the entire research set, alongside a regulatory score of 10.0 of 18.0 and Evidence Confidence of 70 of 100, exactly at the minimum required to be ranked at all. It places tenth with a Clinic Quality Score of 63.5. Clear disclosure of a thin evidence base earns the points the transparency domain awards, but it does not substitute for the regulatory record and it does not lift the total.

Items that earn zero points

The framework treats commercial and editorial relationships as disclosure obligations, not scoring inputs. Advertising spend contributes nothing. A commercial relationship with the publisher contributes nothing. Appearing in a sponsored listicle, press release or syndicated promotional article contributes nothing, and under the evidence standards that material is graded E7, a discovery signal with low verification weight.

This is the rule that makes publisher affiliation auditable rather than merely denied. International Plus is affiliated with this publisher and currently ranks first with a Clinic Quality Score of 86.0 of 100. Its regulatory score of 18.0 is a domain maximum, and readers can check whether the published domain figures sum to the published total. They do, for every clinic in the ranked set. That check works because affiliation is excluded from the arithmetic and disclosed alongside it.

What earns points and what does not

Limitations of this assessment

This is a documentary assessment built on published and issuer-confirmed evidence. It is not a clinical audit, an inspection, or an accreditation decision, and this publisher holds no regulatory standing.

Three limits apply directly to these two domains. First, the framework structurally favours clinics that document well. A clinic with excellent regulatory standing and poor publication habits will score below its real position until better evidence reaches the register. Second, differences of 0.5 points carry little meaning. The gap between a 6.0 and a 6.5 transparency score reflects a documentation judgement, not a measurable difference in patient outcome, and the same caution applies to the 0.5-point gap between the first and second clinic overall. Third, scores are snapshots. Authorisations lapse, accreditations are renewed or withdrawn, and policy pages change without notice.

Nothing in these domains is a clinical outcome measure. A regulatory score is not a success rate, a survival rate, a complication rate or a guarantee, and nothing here constitutes medical advice or a treatment recommendation.

Frequently asked questions