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The pros and cons of dental tourism
By Sheri B. Doniger, DDS

September 21, 2011 -- Editor's note: Dr. Doniger's column, Dental Diaries, appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.

I have a patient who just built a home in Costa Rica. He currently visits there for weeks at a time, and plans to stay for months at some point. He has a lower appliance that replaces his lower anterior teeth, and he is also missing his lower first molar.

We have discussed implant replacement for years. Now that he is spending more time in Costa Rica, he informed me he is looking into getting his implants down there.

His main reason for wanting the implants down in Costa Rica is the cost. He knows that many people go abroad to get their dentistry, and Costa Rica is one of the most prevalent places these tourists visit. In addition, he will be living there half of each year and feels he needs to find a dental home there. According to my patient, all their dentists were trained in the U.S. and have advanced degrees. I happen to know a pedodontist and periodontist, both trained at University of Illinois, who have practiced their entire profession in Costa Rica.

This patient has been a loyal patient for more than 25 five years, but he wants to save money on his dental care. I understand. And he is certainly not alone. According to an article in the Chicago Tribune last month, medical tourism is on the rise. Costa Rica and Hungary were listed as the top two places to visit for restorative dentistry. Costa Rica also claims to be one of the top spots for Americans to go to have cosmetic surgery and reconstructive dentistry, second only to Mexico. Of the country's 30,000 medical tourists, 85% are Americans.

I live in an area that boasts many different nationalities; more than 60 languages are spoken in our local schools. I have neighbors who return to Romania to have their dentistry done each summer, and I have heard of other people going back to their home countries for many treatments, including bariatric surgery, cosmetic surgery, and other costly procedures.

According to the Chicago Tribune report, the cost of dental crowns in the U.S. range from $800 to $1,200 (I know some practitioners charge more), while fees outside of the U.S. are between $200 and $600. For someone, like my patient, with time and money for vacation on their hands, this is a highly attractive option. So how do we compete?

I did discuss the continuity of care issue with my patient. But when a patient decides this is the way to go, we have very little say in the matter. It is similar to a patient deciding to change dentists and coming back to our office. And our practice is not alone. I have spoken to other dentists with the same issue. Patients go to Mexico for winter vacation and have crowns placed. Some go to India for the same reasons.

I know there is little we can do about this situation. When price is a factor, it wins over patient loyalty -- no matter how long the patient is of record.

Sheri Doniger, DDS, practices clinical dentistry in Lincolnwood, IL. She has served as an educator in several dental and dental hygiene programs, has been a consultant for a major dental benefits company, and has written for several dental publications. Most recently, she was the editor of Woman Dentist Journal and Woman Dentist eJournal. You can reach her at donigerdental@aol.com.

The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

Copyright © 2011 DrBicuspid.com

Last Updated kk 9/21/2011 10:55:31 AM

5 comments so far ...
9/21/2011 12:08:22 PM
I love them to get low rate treatment.  That way I can really charge them for doing the retreatment on the lousy failures. 
Who needs those patients anyway?  Purge your practice of those and keep the quality ones.

9/21/2011 12:54:44 PM
I have seen at least 5 patients within last year an a half with foreign dentistry nightmares. We can do something - warn patients!

9/21/2011 1:42:25 PM
A few years ago I attended an ADA conference in Chicago where a speaker representing dental tourism was on the program. During the course of her presentation she said that a person needing major dental care could go to a foreign country and get it cheaper. Part of the pitch was that not only could the person get their dental care at less cost than in the U.S. but also tie the trip in with a vacation.
If the person needed $10,000 in fulll-mouth reconstructive work in the U.S. they could get it at half price and add touring around Europe in the total mix. The country of choice for this dental tourism company was Hungary. The company rep said that Budapest was now the dental capital of the world. When questioned about the quality of care the rep said that many of the dentists in the Hungarian capital were U.S. trained or went to top notch European dental schools.
Ironically, a dentist that was attending the conference with me was Hungarian born and educated in the U.S. He said that he had seen some patients that went on the Hungarian dental vacation and had to do remakes on them and in some cases had to contact the dentist in Budapest to discuss the course of treatment. Luckily he still knew how to speak the language.

9/21/2011 2:20:07 PM
Dear colleagues,
As most of you, I am a dentist. As only a few of you I live in Argentina, where I do my practice. In response to your comments, I must say that I had the opportunity to receive in my practice patients from various parts of the world, some of them from the United States. I must admit that, while I accept patients going on dental tourism, I do not promote it nor advertise.
I must assure you that dentists who do their jobs properly exist in Argentina and any other country, such as exist in the United States. There are also those who do not, also as in the United States.
Do not think that because the work here is economically cheaper in relation to the USA is of a lower quality. Actually, dentistry here is not cheap in relation to our economics. Always colleagues, always, the quality and responsibility of the work depends on the professional, and not on the geographical site where it is practiced. Greetings from Argentina.
Dr. Mariano E. Villarino

9/21/2011 5:22:01 PM
I am a dentist practicing in the Philippines.  And indeed, I receive patients from the US, as well as from the UK, Germany, Australia, Switzerland, and many other countries.  I think the quality of work would really be a reflection of the dentist, rather than the country where the work is done.  In our little corner of the world, we do have access to Emax, Lava, CBCT, Cerec, air abrasion, lasers, and all the other wonderful inventions that make our service better.

I'm the first to admit that, no matter how much care and attention I try to give my work, there will be a few crowns, fillings or veneers that may need rework, albeit very few.  But this is a problem all of us have, correct?

But truthfully, almost 75% of these transient patients come here because they just can't afford treatment at home.  I've had a few patients with temporaries that they've had for a few years, just being recemented or repaired by their hometown dentist because they cannot afford definitive and final work.

And so many patients take the risk, flying to a foreign land to see a dentist who they hear about or surfed online, because they simply have no choice.  Rest assured that some of us overseas dentists really do want to help these people.  As doctors, that's why we took this route in life, right?
Try to visit our little corner of the world, and you may be mildly surprised about all the wonderful things you may be missing!
Dr. Carlo Pio Tripon
Makati City, Philippines

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