Air smiles: Is economy-class dental tourism worth the risk?

The cost of dental treatment abroad can come in much cheaper — but it’s important to do your research first, writes Áilin Quinlan.

How far are you prepared to go and how much are you prepared to pay for that perfect smile?

Because if you’re going to fork out significantly less for expensive treatment such as implants, crowns, veneers or bridges, expect to travel thousands of miles abroad.

Social media and the influence of the all-pervasive ‘Hollywood smile,’ allied with advances in cosmetic dentistry, have made us painfully conscious of the state of our teeth.

But that flawless, icy-white smile comes with a hefty price tag. To offset the cost, Irish people are booking ‘dental holidays’ as far afield as India, Dubai, Hungary, Malta, and Turkey, while Poland is becoming increasingly popular as a dental tourism destination.

In some cases, people say they’re paying a fraction of the cost of similar treatment in Ireland. The most popular treatments sought by Irish dental tourists are implants, bridges, and crowns, according to Ildiko Cservenyak, managing director at Access Smile, which has a clinic in Budapest and a sister clinic in Dublin.

“The majority of the people who decide to go abroad for dental treatment will be people who may need a significant amount of work done,” she explains.

“Prices vary in Ireland but generally for bridges, crowns, and implants in our clinic in Budapest, a client will pay around half what they’d pay in Ireland.

“Root canal treatment costs about one-third of what it would cost in Ireland so the difference can be quite significant if extensive dental work is required,” she says.

Root canal treatment work usually costs from about €250-€300 in Ireland, depending on the kind of tooth treated, while implants can cost between €1,000 and €2,000.

Retired civil servant Carmel Murray jetted to India for treatment after being diagnosed with gum disease in Ireland and being told it would cost over €6,000 to resolve the problem.

After hearing a radio programme which mentioned Dr Biju Thomas, a specialist implantologist and consultant maxillofacial surgeon, who trained at St James’s Hospital in Dublin, and who now runs clinics in India and Dubai, she emailed him, describing her problem in detail.

Carmel, from Blackrock, Dublin, was told that if she was prepared to travel to India, Dr Thomas would treat her over a 10-day period: “There was a lot of work involved — my gums had to be built up, there were several extractions, some crowns, and six implants,” she recalls.

Carmel saw Dr Thomas in 2004 and again in 2008 to continue the treatment. Each time she went for about two weeks. Her last visit took place in 2017, when she stayed in India for a month.

“The cost of the treatment was about 50% to 60% less than in Ireland,” says the 76-year-old, recalling that she liked to work her annual holiday around her visit to the dentist.

“I could never have afforded to get this treatment in Ireland. I’m very happy with the treatment and have had no problems in all of this time.

“People used to say to me ‘what will you do if anything goes wrong? You’re thousands of miles away.’ But I always said I could go to a dentist in Ireland!”

According to Dr Thomas, who has been in practice for nearly 20 years, patients who attend his clinics in India or Dubai can save up to 80% on the treatment cost in Ireland.

A quick Google reveals that flights to Dubai, and a week’s accommodation there can potentially add up to €1,500, a hefty sum on top of dental treatment. However, most of Dr Thomas’ Irish patients travel to India, he says.

Return flights to Kerala come in at between €500 and €600, and accommodation is much cheaper there than in Dubai, so, if you work your annual holiday around it, as Carmel did, the actual cost of your dental work is further reduced.

“People come to me through word of mouth and because of the cost and the expertise,” explains Dr Thomas.

“I am a maxillofacial surgeon and can do these complex procedures very quickly and efficiently.

“Most of my patients are coming for full mouth reconstruction and would be in their fifties — these would be people who have had multiple teeth extracted in the past and they want dental implant treatment which is very expensive in Ireland,” he says, adding that the cost of an implant in India is about €500 compared to up to €2,000 in Ireland.

“I have been carrying out complex implant treatments for the last 20 years and am very specialised.”

According to Fintan Hourihan, chief executive of the Irish Dental Association, it’s not possible to say just how many Irish people engage in dental tourism annually.

Anecdotally, it’s estimated that large numbers of Irish people opt to travel abroad when they discover they need a significant amount of dental treatment.

Dr Thomas sees significant numbers of Irish patients every two months at his clinic in India, while Davor Mekterovic, managing director of Dental Hungary, which has operated a clinic in Ireland since 2005, says the clinic sends an average of five people each week to its clinic in Budapest for popular treatments like crowns, veneers, and implants. Patients save up to 70% on the prices they would pay here, he claims.

“They get everything done under one roof and some work a holiday around it — for example, someone might come to Budapest for five or seven or 10 days.”

‘I was very self-conscious’

When Dublin housewife Mary Vaughan, 59, was quoted nearly €5,000 by an Irish dentist to have four crowns, she decided against proceeding with treatment.

However, four years later, her condition was much worse. “My jaw was shrinking, a tooth was pushing forward, I had a recurring abscess and there were cracks in my front teeth. I was very self-conscious,” she recalls, adding that Dental Hungary came recommended by a number of people.

Last summer Mary had an initial consultation, at which she was told she needed an extraction, some bridging, a root canal, and 22 crowns. In November she travelled to Budapest for eight days for work costing €8,900.

“I estimate the same work would have cost me about €28,000 in Ireland for all of this. My husband has now decided to get implants in, with the same company. I was very pleased with the work.

“Prior to this I shied away from having photographs taken — now I can smile!”

So are Irish dentists overcharging? No, says Ildiko Cservenyak, who points out that although dentists in Ireland and Hungary use the same materials and hi-tech equipment, property prices and salaries are far lower in Hungary: “It’s much cheaper to rent a premise there than in Dublin.

“Also, salaries in the dental sector in Hungary are much lower than in Ireland at less than half, or about a third of what staff would earn.”

Davor Mekterovic is not quite so sure: “If it’s about cost of living and overheads why do Northern Ireland dentists charge 30% to 40% less than dentists in the Republic?

“There may be big differences in salary and lifestyle costs between Ireland and Hungary, but I can’t see much difference in the cost of living between Ireland and Northern Ireland.”

‘I have a whole new mouth’

Colette Coyle who got all her necessary dental treatment done in Budapest earlier this year. Picture: Moya Nolan

Colette Coyle, 59, a medical skin technician who lives in Dublin, travelled to the Access Smile clinic twice last March for two days each time.

In all, Colette had eight teeth treated, including an implant and two crowns.

Her treatment cost €4,000, less than half, she believes, what the same work would have cost in Ireland.

“Even with the cost of accommodation and flights worked in, it was significantly less than I would have paid in Ireland, and I’ve had no problems.

“I have a whole new mouth, and the whole thing was stress-free. For me it was all about getting all of these teeth done and dusted — if I’d had it done in Ireland, I’d have been forever trying to pay for it piecemeal. Now it’s done and it’s perfect and I haven’t an issue in the world.”

All very well — but what about aftercare when your dentist is abroad? “In terms of aftercare if it is something small our clinic in Dublin will look after it,” says Mekterovic. “If there is need for remedial treatment, the patient will go to Budapest.”

Cservenyak explains that the same Dublin clinic that carries out Access Smile’s assessments is geared to provide aftercare as well as check-ups and dental hygiene treatment.

According to Dr Thomas, patients just need check-up and cleaning following their implants, “which is something they can get with their local dentist”.

So far so good, but, points out Fintan Hourihan, people should be aware that there is “strong competition in Ireland for most everyday treatments”.

He points to the findings of a survey conducted by Dental Boosters in May. The study of more than 1,200 practices found extensive competition and variation on fees for most treatment items which means, if people shop around, there is usually good value to be had.

Furthermore, while it is true that crowns and implants may be cheaper abroad than in Ireland, he emphasises, people should always be aware that the gold standard for material used in crowns, for example, is porcelain.

People should always check to ensure that plastic crowns are not being used in their treatment.

“It can be a case of apples and oranges,” he says, adding that, in general, the biggest difficulty for people having overseas treatment is undergoing too much dental work in too short a period of time.

“If too much is done in too short a time span, complications such as infections may occur,” he says.

There is no statutory protection for people if things go wrong with dental treatment abroad, he warns, adding that it’s important for people to check how dentists are regulated in their destination country.

“Is there a fitness-to-practice procedure, for example, is there professional indemnity insurance for people?

“Is there a complaints system in place? If things go wrong you need to know in advance how your complaint will be addressed and that can be very difficult if you return home and realise something is gone wrong.”

There are no plans for regulation of prices within the EU, he says, adding, however, that while “people like to have a bright smile”, it is important to have good gum and oral health, and the best way to avoid problems is to see your dentist regularly.

It’s unlikely that most of us will fly abroad for regular dental treatment — as the Dental Boosters survey shows, prices for everyday dental work are competitive. However, if extensive — and expensive — work needs to be carried out, the often very significant cost savings of having dental treatment abroad are bound to be a deciding factor.

But remember, always, always do your research first.

- Be informed about the treatment you need. Speak with your dentist beforehand, who will be able to offer advice based on your dental history.

- Research the treatment proposed, the clinic where the treatment will be carried out and the dentist who will be performing the treatment. Word of mouth is a good indicator.

- Establish if the country to which you’re planning to travel has a similar regulatory body for dentists to Ireland and if it is compulsory for all dentists there to register with that regulatory body. You can find out about health regulators and professional bodies in other countries at www.healthregulation.org or, for dentists, www.fedcar.eu

- Check that your dentist has professional indemnity insurance cover.

- Think about language and cultural differences which may impede accurate interpretation of verbal and non-verbal communication.

- Consider that your lack of familiarity with the local medical system, potentially limited access to your past medical history and possible unfamiliarity with your drugs and medicines, may pose challenges if complications in treatment arise.

- Ensure that you are satisfied with arrangements for follow-up care should there be complications.

- Ensure you are clear on how financial matters will be resolved if costs escalate, such as in the case of complications, as legal recourse may be limited or difficult to obtain.

Suggested questions:

- How will I determine the qualifications and experience of the dentist who will be treating me when I am abroad?

- Will the dental team who will be treating me be able to communicate with me in a language I will understand?

- What aftercare will be provided?

- If I need any remedial work and have to return, who pays for flights, accommodation and for the additional work needed?

- Does the dentist have adequate professional indemnity cover to carry out all dental/ surgical treatment including specialised procedures?

- What are my legal rights if something goes wrong with the treatment provided or if I am unhappy with the result?

- If I need remedial work for any reason including pain, bleeding or infection and do not want to travel back to where the original treatment was carried out, can I have it done at home? How will this be organised for me? Who pays?

- Who can I contact for advice after treatment?

- Will my records be kept in my language or the local language?

- Will I be given all my records after treatment?

For more information visit the Irish Dental Council website


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