Should you travel overseas for dental work?

Posted on 10th April 2019

Our president, Jenny Ball, offers her thoughts on dental tourism: 

I am heading to Bali for a few days in June. Some people go to Bali to escape the cold and others go Bali and beyond to have dental treatment. I prefer, when I need to have treatment done (for example new RCT, root bleaching, new post and new crown) to have it done in Perth.

In March, an article appeared across social media: “Aussie woman reveals impressive results of dental transformation.” A woman from Perth shared the incredible results of a budget $5,600 dental procedure after seeking treatment on her “rotten” teeth in Seminyak, Bali. She transformed her appearance during the cosmetic surgery getaway, undergoing a “whole mouth reconstruction” during a 10-day trip. If she had had the same treatment in Perth, it would have cost $24,000.

This type of social media post/article appears every few weeks. There was another similar story in one of the weekend papers a few weeks ago.

More and more Australians are heading overseas for dental care because of the perceived expensive costs involved in having the treatment done here in Australia. Heading overseas for treatment seems attractive because, for a significant reduction in price, they can receive treatment and have a holiday. The problem is that most of that expensive treatment is complex, which has inherent problems no matter where it is carried out.

Whilst researching information for this commentary, I found the following comment on a website, which made me cringe: “An initial assessment, X rays, a deep clean, 4 root canals and posts, 9 Zirconia crowns and a new partial denture (5 teeth) and medicines. Treated like a king with massages, meals (in the clinic) and personal car delivery to and from appointments. Also pick-up and delivery from and to the airport, not to mention the luxury accommodation provided by the clinic (optional at A$65 per night for 2). Total cost A$9500 and work completed in 4 appointments over 7 days. Totally professional care and the Thai humility, friendliness and efficiency made this an experience to remember. Couldn’t be happier.”

I used to get asked by my patients what were my thoughts if they had the treatment I suggested overseas. Several years ago my first reply was: “Don’t expect me to fix it if it goes wrong.”

So, what sort of advice should we be giving our patients? We should be tempered in our response, and rather than saying outright not to go, we should provide them with some information and examples that they might like to think about before actually committing themselves.

We, as practitioners and educators, need to give our patients information they can understand and that will not overwhelm them. We need to tell them to find out all the relevant information and understand how overseas dentistry works before they decide to engage with it.

Remind them about your infection control proceduresand that in Australia there are very strict Government rules about this. Overseas countries may not be so strict. Suggest that they allow plenty of time to have procedures done. Use an example of treatment that you have done on them and discuss how long it took. If they need to stay longer, suggest that the cost of accommodation will add to the expense.  Ask them what they will do if the treatment fails within a short period of time or even in the long-term once they have returned to Australia. How long do they expect/ think that their treatment will last? If it has to be redone overseas every few years then the costs will be negated.

Explain that if you carried out the treatment and something simple went wrong shortly after the treatment (not that it would) that it would be rectified, within reason. We have all had patients return a few days after having a crown inserted or restoration placed saying the bite is still not quite right. If the crown was inserted overseas, the patient will have to pay to have this issue remedied.

Implants take time before they are integrated and by the time they have not integrated the patient would have  been home for a number of weeks. Sometimes a corrective treatment can end up be more expensive than if the original treatment had been performed in Perth.

Unfortunately, there are no strong population-based studies that prove overseas dental treatment leads to poor outcomes only anecdotal cases. This is an issue that needs to be addressed.

Federal ADA has a Dental Tourism Fact Sheet on its website, which covers other issues. I suggest that you familiarise yourself and staff with it. Sometimes it is your front office/ patient co-ordinator staff that the patient talks to about this (as they are the ones who pass on the treatment plan and quote).

As an aside, I found this comment numerous times in researching this commentary:

“Holidays come and go but the effects of dental treatment stick around for a lot longer.”

And the reason for my few days in Bali? To celebrate my brother-in-law’s 65th birthday.