Dental Tourism

15th March 2021

Dental Tourism

Dental Tourism and Dental Implants

You would imagine dental tourism and in fact tourism in general is a general moot point at the moment and I mean there is no denying that COVID has put a pause on travel. However, the current situation has given us all a thirst for making our next holiday count. There have been a few mentions in our house that our annual 3-day trip to Wicklow might be replaced by 2 weeks in Florida in 2022. Another thing I am hearing a lot of during new patient telephone enquires at the minute is “I am considering once this is all over going abroad to have my teeth fixed”. Dental Tourism has been around for a quite a few years now and has most recently been in the news in the form of that photo of Katie Price with ‘pointy teeth’ and closer to home in the sad case of the death of local man Richard Molloy. No details have been given to the public and it would be unfair to speculate exactly what happened in this situation.

I expect once “normality” returns that dental tourism will make a bounce back. Demand has potential to be higher than ever before owing to the increased pressures on dentistry in the UK as a whole. As a consequence of the pandemic, there is very long waiting lists and increased costs. Of course you would expect me to be biased and try to encourage the public to stay local and yes well there is no denying that! Like yourself I have heard and in fact seen lots of positive experiences and results. If it is something you are considering here are some things to research before you jump on a plane!

Registration

In the UK all dentists and dental nurses must be registered with the General Dental Council in order to practice. They are an independent organisation which regulates dentists and dental care professionals in the UK. They set dental standards, hold a register of qualified dental professionals, quality assure education and investigate concerns about treatment or conduct. The standards are available online and are an extensive read, (take a look) As part of this registration all dental professionals must complete a certain amount of continued professional development every five-year cycle.

At Moira Cosmetic Dental the heartbeat of our practice is our desire to be continually improving both our clinical standards, developing our practice, enhancing the patient experience and reaching our full potential. All of our dentists and team members are expected to far exceed the minimum amounts of required continued professional development, we are all focussed on expanding our training. (During the first lockdown Natasha, one of our Implant nurses completed enough online courses for a 5-year Cycle!)

All of our team have training and or qualifications above the basic requirement. This includes our administrative and reception team who are all GDC registered. Continued professional development benefits our patients as they can be sure the team treating them are not only engaged but are up to date in the recent developments and methods available, however this amount of training will add to the overall cost of treatment, it will also add to all over better patient care. What is the equivalent to the GDC in the country which you are thinking of having dental treatment? What is their standards? And how seriously does the practice take these standards, do they scrape by to meet these standards or do they use them as a basis and framework to improve upon?

Regulation

In Northern Ireland all dental practices are registered with The Regulation and Quality Improvement Authority (RQIA) which is an independent body responsible for monitoring and inspecting the availability and quality of health and social care services in Northern Ireland, and encouraging improvements in the quality of those services. We are annually inspected and the inspection reports are placed online and are available to the public. We are delighted to always have fantastic reports and this is reflected in the hard work of both management and the team with special emphasis placed on the role of our decontamination lead nurse who makes sure our sterilisation and decontamination exceeds expectation. Ensuring the safety of patients and staff and is extra important with the challenges of COVID-19 as a highly infectious disease.

Accountability

In the UK all of our materials and labs have to be of a certain standard and meet requirements. This is especially important when considering Dental Implants. We are proud users of Straumann® dental implants which offer a life time guarantee on their components. Which leads us to consider, what if something goes wrong and you need to source local dental treatment. This could be a whole blog article in itself here are the main points:

1. Each implant system comes with its own “took kit” and parts can be ordered online- if you have your dental implant placed in another country the implant system might not be widely used in your home country and you will struggle to find a dentist that can actually help. Sometimes we see patients return from abroad and can’t even find out what brand of dental implant has been used.
2. Local dentists will be reluctant or simply can’t help! Especially if the dental work you have had carried out is sub-standard, you will most likely need referred to a specialist. This reluctance is because once a dentist tries to fix something they will shoulder some responsibility for the outcome. Dr Murray Smith seen a case recently where a patient presented with their bridge and dental implants in their hand asking can you put this back in? this is unbelievably concerning for Dental Implants to fail in this way and it is likely that this patient will have lasting damage as a result. “A survey by the Irish Dental Association in 2010 found that 75% (6000 patients) of people who had travelled abroad for dental surgery had then subsequently re-engaged with the Irish dental system and required corrective work.” (1)
3. Maintenance is an imperative part of dental implant treatment. Dr Derek Bingham our implant dentist reviews his patients with the help of Rachael Lilley, our hygiene therapist, annually. Depending on your own risk factors, and treatment outcomes, Derek will also recommend a programme of hygiene visits and maintenance to ensure you get as many years as possible out of your dental implants. This preventative approach is often not one that travels well.

Consent

The GDC standards talk about the importance of consent. Standard 3 solely relates to the issue of consent it says: “You must discuss treatment options with patients and listen carefully to what they say. Give them the opportunity to have a discussion and to ask questions.” (2) The most staggering thing we find with patients presenting with complications from dental treatment abroad is that they have a very poor understanding of the treatment they had completed.

The guidelines in the UK say that patients must:

• “receive full, clear and accurate information that they can understand, before, during and after treatment, so that they can make informed decisions in partnership with the people providing their care.
• A clear explanation of the treatment, possible outcomes and what they can expect. • To know how much their treatment will cost before it starts, and to be told about any changes.
• Communication that they can understand.
• To know the names of those providing their care.” (3)

Lunt N, Smith R D, Mannion R et al, concluded from their research “Medical tourists are unlikely to be fully informed or understanding of all associated clinical risks.” (4) From the list above which area would you be happy to compromise in?

The two main reasons people give for choosing to travel for dental implants are usually:

1. Cost
2. Quick Fix

Unfortunately, if something were to go wrong it is specifically these two points that immediately crumble. Take this example in a case study completed by Lunt N, Smith R D, Mannion R et al, “One respondent (DT4) did not have a positive experience. Having travelled for what she called a full restoration of her smile, numerous implants were provided. In fact, the implants were initially placed in the UK before the respondent travelled to Hungary for the subsequent stages of treatment…The respondent has subsequently had all of the work redone bringing the total cost to in excess of £40,000 and has suffered for a number of years while the problem was being addressed.” (5)

In conclusion, if you are interested in having dental implants, I would ask your own dental practice who they would recommend locally. If you want to know who I would recommend, of course I would say Derek Bingham at Moira Cosmetic Dental, Why? You ask…. Because I get mates rates 😉

References

1. Irish Dental Association. New survey shows 6,000 patients per annum receive corrective treatment following dental work abroad. 12 May 2010. URL: http://idamembers​.hostireland​.com/resources​/news/showarticle.jsp?id=959
2. https://standards.gdc-uk.org/pages/principle3/principle3.aspx
3. https://standards.gdc-uk.org/pages/principle3/principle3.aspx
4. Lunt N, Smith R D, Mannion R et al. Implications for the NHS of inward and outward medical tourism: a policy and economic analysis using literature review and mixed-methods approaches. Southampton: NIHR Journals Library, 2014.
5. Lunt N, Smith R D, Mannion R et al. Implications for the NHS of inward and outward medical tourism: a policy and economic analysis using literature review and mixed-methods approaches. Southampton: NIHR Journals Library, 2014.