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Dental Care Abroad – Luck of the Draw?

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Dental Care Abroad – Luck of the Draw?

Dental Care Abroad – Luck of the Draw?

June 13, 2006
By: Jean Johnson for Dental1

Personally, I like my vacations straight up, without needles and drills and scalpels. But say what we like about the superior care dental care Americans enjoy, the bottom line is that dentistry can be pricey and people are often without dental policies that cover their work adequately. That’s why the growing trend of folks leaving home for distant places to get cheaper dental work is cause for serious contemplation.
Take Care
Considerations when evaluating whether or not to have dental work abroad:

What is the dental professional’s background? Training? Experience? Rates of success? Are there patients you can contact to hear about their experience?

How many trips will be involved? What will the overall savings be when travel costs and time away from home is factored in?

What is the patient’s recourse if something goes wrong? Legal system in the country of choice? Cost of return trips?

Overall dental health? How does seeing different dentists for various problems influence your overall oral health? What benefits accrue from visiting a single clinician over the years? Are these significant enough to warrant paying full American prices for extensive dental work?

The Mexican Connection

Take, for example, Congressmen Charlie Norwood’s (R, Ga.) observations. “In the Mexican border towns, dental care costs less than half of what we pay here in the United States. That has led to a growing dental tourism industry in our Southwest. But according to travel industry warnings, 60 percent of those performing dental services are not properly trained or licensed, even by Mexican standards.”

Norwood continued, “Some patients are lucky and find a qualified dentist who delivers good treatment at a bargain price. Others are not so lucky and suffer serious injury from unqualified hacks, and end up hospitalized or worse from infection. Quality in dental care in the border towns is found solely in the luck of the draw.”

But everyone who lives in the Southwest knows that you have to go beyond the border towns to really appreciate Mexico. “Of course things will be substandard in the border towns,” said Linda Thompson of Williams, Ariz., who has traveled to Mexico throughout her life for family vacations. “That’s just no comparison to what things are like actually down into Mexico.

“We know. We’ve been going there for years now. And when my husband’s teeth started to go on him, I just booked him some appointments at this one office I found and they took care of the extractions and making him dentures. He didn’t have any trouble at all and that was a good five years back. We raised the four boys and if we were going to have any fun at all – like take our camping trips down to Mexico – we couldn’t be spending all the money on dental care as the American system seems to expect. My husband is a house painter and has worked hard, but we only have so much to manage on and our mortgage to take into consideration.”

Dentistry in Thailand an Option for Some

While Thompson accesses dentistry closer to home, when I was in the early stages of planning for my dental implants (see Silk and Jazz for my personal dental implant saga on Dental1.com) expatriate friends living in Thailand suggested I look into having my work done there.

“One of the women I ride with is from Australia and she came up. She had several implants placed,” said Sandy Kypfer who, with her geologist husband who works for an oil company, currently resides in Thailand. “It’s a lot cheaper over here. That’s for sure. And my friend seemed happy with the results she got.”

Call me conservative, but I stayed home and bit the cash bullet. As one dental professional I spoke with at a Portland, Ore., meeting said, “Where did these people get their training? In American schools? Or where? Also if something goes wrong, then what? It’s a long way between here and Thailand.”

Still people are doing it – and not just Mexico and Thailand. If it’s a rich Turkish coffee with an unmatched aroma you want to sip between your appointments, just hop off on a flight to Istanbul. Or, if the smell of cumin seeds popping in hot oil and briny lemon pickles gets your attention, India offers up services for dental tourists along with centuries old first rate vegetarian cuisine. Then again, like so many Brits whose culinary tastes are apparently less demanding, Hungary might be just the bet.

Kreativ Dental Clinic – Hungary Drawing Numerous Europeans

According to an April 2006 article on what the BBC called a boom in dental tourism, “business is brisk” in Hungary. The piece profiles the Kreativ Dental Clinic in Budapest where Dutch, Danish, Irish and English patients have taken advantage of “bargain dentistry.” Rates for dental implants run from 1,000 to 2,000 pounds in Britain while in Hungary implants are 580 pounds. Root canals, as well says the BBC, drop dramatically to 250 pounds in Budapest as opposed to 800 pounds in London. And of course, when a patient needs considerable work, savings can mount to impressive figures quickly.

One man interviewed by the BBC, Bill Hunter, an oil rig manager from Edinborough, needed root canal work, four oral implants, and 12 crowns. The fee he paid in Hungary over four visits – 7,000 pounds – was 10,000 pounds less than a private practice quote he got in Edinborough. He also said the distance of 900 miles doesn’t bother him.

“If there are any problems, I’m a big boy,” said Hunter. “I’ll take a couple of aspirin and get on a plane. The ticket will cost me the price of a consultation back home.”

The California Dental Association Speaks Out

The Academy of General Dentistry’s staff writer, Kristina Lynch, did considerable research on the article she wrote on dental tourism. Part of her effort was devoted to a response to rising dental tourism trends by American dentists.

One of the pundits Lynch consulted was Robyn Crimmins, vice president of risk management and communications for The Dentists Insurance Company, a subsidiary of the California Dental Association.

Crimmins said dental tourism “hinders a U.S. dentist’s ability to provide thorough, continuous care. Sometimes patients will spend half of their time in another country and half of their time here. When they’re here, they’ll come to the dentist basically for emergency treatment only and have bigger procedures, such as implants, done in the other country, presumably because they’re more comfortable there, or they spend more time there – or maybe because it’s cheaper.

“The dentist here feels there is no continuity of care, because the patient is only coming to them on an emergency basis. Dentists do get nervous about that because they feel they aren’t able to control what the dentist out of the country is doing and might believe the care is substandard, although that is not always the case.”

So far Crimmins said there have been no legal issues stemming from patients’ globe trotting excursions. Still, she thinks caution is in order.

“Dentists should talk to the patient and explain why consistent visits to one dentist are important for achieving complete dental care,” said Crimmins.

Crimmins also noted that dentists need to spend extra time charting to ensure that they do not end up liable for work they did not perform or work that is unregulated by American dental codes and standards.

“Dentists can protect themselves in these instances by completing a thorough examination and carefully documenting the patient’s baseline condition,” said Crimmins, “so the dentist can clearly delineate the treatment he or she provided from the treatment performed by another dentist.”

Legal Issues

The Academy of General Dentistry’s Kristina Lynch also contacted Nick Konev, who owns the newly formed Mexican Dental Vacations company complete with what he describes as a world-class clinic that he established in 2005. Not a dentist, the businessman Konev seeks to attract good dentists and provide quality care at a fraction of U.S. costs.

While his first year in business has been promising both in patient response as well as interest from American dentists who find living and working in Mexico an attractive alternative to their practices in the United States, Konev admits that legal issues could be a problem.

“Once they return to the U.S., patients are more or less on their own. There is nothing that they can do. We try to take care of problems on our end before it gets to the point where it’s a malpractice issue, because then the patient can feel powerless. It will take forever before the legal system will award them anything, or even get it in front of a judge. When a patient comes to work with us, we notify him or her that we are insured for malpractice, but the legal system in Mexico is slower than the United States. It will be years and years before a case is finalized.”

Caveat Emptor! Let the Buyer Beware

On that happy note, caveat emptor – let the buyer beware! While many like Bill Hunter are thrilled to have save thousands by having their dental work done abroad, the game is nonetheless just as Congressmen Charlie Norwood described it: All in the luck of the draw.

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