It’s THAT Time Of Year Again – Dental Tourism – What Do You Do If Confronted With A Disaster?
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- Published: Wednesday, 25 August 2021 08:43
- Written by Chris Tapper
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The phrase ‘Dental Tourism’ will almost invariably invoke terror in the heart of many UK dental clinicians. So what do you do if you’re faced with a dental disaster created abroad?
With hundreds of online companies offering massive discounts on dental treatment and hotel packages at holiday resorts, it’s hardly surprising that the global dental tourism market is expected to hit £4.2billion in 2025.
Intrado GlobeNewswire said Europe is expected to emerge as the “Most lucrative market for dental tourism owing to presence of countries such as Hungary, Poland, and Spain which are major dental tourism locations. The leading European countries for dental care accounted for more than 20% of the global dental tourism market during the forecast period.”
With websites like DailyTravelNews.com recently stating “Dental tourism is simply traveling abroad to get dental care that you won’t get at home,” it can sound appealing to patients requiring complex treatment who are struggling either with access, or cost.
But with the growth of dental tourism, the website’s statement “The fact that some countries offer cheaper dental care does not mean that all dental clinics are legit. Some of them could be scams posing as real clinics because they know people flock into their country for dental care,” may not be that effective in putting people off.
The internet and dental chatrooms are full of the tales of dental treatment gone awry.
One such story was outlined by New Orleans cosmetic dentist Dr Duane Delaune, who wrote “A woman had travelled to Costa Rica thinking she’d be saving a large amount of money. Instead, she was left with a disastrous smile makeover and severe damage to her bite which has her in so much pain she can barely eat.”
“The price tag to fix this will be over $30,000. Money she doesn’t have. When she hired an attorney in Costa Rica and had other Costa Rican dentists to tesitify that her bite was destroyed by this dentist, the only place where she could get legal recourse there told her she was the felon because it is illegal there to complain publicly about a dentist until he’s been convicted.”
“She ended up having to flee the country without any recourse. While the dentist in questions website looked professional, there were red flags. Unfortunately, only a dentist would have recognized those.”
Researchers at the University of Otago found that 97% of 337 New Zealand dentists surveyed in 2016 had “Encountered dental tourists at least once or twice a year, usually because they required remedial treatment.”
The Otago University website said that while some treatment is successful, tourists with failed treatment seek remedial work once back home.
“The most important issue was a lack of follow-up maintenance and a lack of availability post-treatment. About half of the respondents identified lack of treatment planning and lack of treatment records to be issues,” wrote Liane Topham-Kindley.
“Many dentists were concerned that patients are unaware of the poor quality of work often being carried out.”
"Patients are unaware of the poor quality of the work they receive and the difference in standard of care compared to New Zealand dentistry. Patients are often over-treated and inappropriately treated with irreversible damage to their teeth and no apparent discussion or awareness of treatment options," another dentist said.
In January 2021, the British Dental Journal published ‘Dental tourists: treat, re-treat or do not treat?,’ by Shoukat Ashiti and Catherine Moshkum.
The authors explored the reasons for patients travelling abroad for treatment.
“It could also be that patients requesting a more controversial treatment option feel the need to travel abroad as clinicians in the UK may not feel comfortable in providing this, both ethically and medico-legally.”
“For example, patients who do not like the colour or shape of their own natural teeth and are looking for a ’Hollywood smile’ may be in search of a dentist who will provide extensive indirect restorations on their otherwise healthy teeth.”
“If a patient were to attend with failing implants, perhaps removal may be acceptable on the NHS, but surely not their replacement. Imagine the situation where a patient has had several implants placed abroad, but they have not been restored; would any dentist try to restore these for the patient?”
“If a dentist in the UK accepted to restore them and they later fail, who is responsible? If no dentist was willing to restore them, could we really justify the surgical risk of removing them and starting the treatment again if the unrestored implants did not appear to be failing? It could be that we do not even recognise the implant system that has been used, even if we were willing to restore them.”
“Even if the patient signed a disclaimer accepting that failure is a possibility, it would be difficult to prove whether the implant itself or the restoration is the reason for failure. Does the dentist’s fear of litigation lead to the patient ending up in a half-treated difficult predicament?”
Faced with such a case of failing treatment, Dr Doug Hamilton, dental adviser at the Medical and Dental Defence Union of Scotland, advised on the MDDUS website “Most practitioners will feel a degree of empathy with their patient’s plight.”
“However, in such instances, the UK dentist is not required to bear any of the costs of remedial work. In fact, correcting unsuccessful dentistry is often more complex than carrying it out in the first place and practitioners must not, through some misplaced sense of obligation, involve themselves in work that is beyond their ability.”
“Instead, the presenting condition must be carefully assessed and scrupulously recorded, making use of photographs and justifiable radiographs where applicable, before a written estimate is given for work which the dentist feels will be beneficial. At this stage, it is up to the patient to decide whether to proceed on this basis or return to the dentist who provided the original treatment.”
Dr Hamilton concluded “Dental tourism as an inescapable facet of modern dentistry and it is an option increasingly explored by patients hoping to save money on the more complex components of their dentistry. In dealing with these patients UK dentists should explain the potential for additional costs and clinical complications which may result from having treatment abroad. However, regardless of the advice provided, they are not obligated to rectify any adverse outcomes.”
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