The Phenomenon of the inciDental Tourist

It all began in the UK
British dental patients are flocking abroad to avoid long queues for access to dentists back home. Cheap flights and bargain prices for treatment are additional incentives.

Some dentists in England and Wales are reporting they have to turn away National Health Service (NHS) patients because local health authorities have run out of money to pay them. The dentists blame changes in government policy introduced in April 2006 designed to improve access to NHS dentists and make fees fairer. However, many dentists were unhappy with their new terms and conditions and it is estimated that some 2,000 dentists (one in 10) consequently left the NHS.

As a result, in that year alone more than two million Britons were unable to get dental treatment, so it is no surprise some are resorting to extreme measures to care for their teeth.

Many dental tourism agencies have mushroomed in the UK offering cut-price treatment combined with a holiday break. Prices are so much lower in Eastern Europe that it is economical for patients from the UK to fly out, undergo surgery, take in a sight seeing tour and return home. Besides dental tourism agencies, British patients are increasingly using the internet and budget airlines to seek out cheaper alternatives to private dentistry at home.

Flocking to Poland and Hungary
To do the same dental treatment in a private dental practice in Great Britain would be three to five times more expensive than in Warsaw. Polish dentists are expecting a boom - the number of dental tourists is expected to increase by 20% in 2008.

Dentists in Hungary are used to dealing with foreign teeth. Austrians, Germans and other Europeans for decades have been crossing the former Iron Curtain to get their teeth fixed, often at jaw-droppingly low prices, literally for a fraction of the price at home. A dental industry has emerged in towns along the border and an estimated one in three Austrians now use Hungarian dentists. The emerging market of British patients is concentrated on Budapest due to its accessibility by three budget airlines.

The Americans join in
Now, a small but growing number of Americans, prompted by soaring medical costs and dwindling insurance benefits at home, are following suit of the Austrians, Germans and British. They're contributing to the rising popularity of dental tourism, a relatively young trend, but part of a fast-growing global phenomenon in which travelers, typically from wealthier countries, visit less-developed nations for dental care mixed with vacation — all at cut-rate prices.

The price factor
One 52-year-old patient’s dilemma was that her teeth were falling out due to a hereditary gum disease and she did not want dentures. She was told the alternative was to have dental implants done privately which would have cost her £52,000 in the UK.

"No way could I afford £52,000," she lamented. Eventually she found she could get the same treatment for £16,500 in Budapest - a 3,360 km round trip that took 12 hours. "It just seems so stupid to get in the car and drive all the way to Luton and catching a flight for a check up and going to another country but I had no option.”

Another patient was quoted £17,000 by a private practice in Edinburgh for root canal work, four implants and 12 crowns. A British dental tourism agency arranged his treatment in Budapest for around £7,000.

Most of British patients who go abroad for dental treatment need extensive work done: bridges and implants, which are not usually available on the NHS. However, with NHS dentists becoming increasingly scarce - just four for every 10,000 people in England - clinics in Hungary are expecting more patients who need routine work such as crowns.

A single dental implant - a metal screw placed into the jaw bone to hold a replacement tooth or bridge - costs £1,000 - £2,000 at a dentist's in north London. In Hungary, they're putting them in for £580. The same London dentist charges more than £800 for root canal treatment and a crown. In Budapest, the price is around £250. Even with the cost of flights, accommodation and return visits, the savings are considerable.

How can they keep costs down? “One reason: the manpower is very cheap,” says a dentist who moved his practice to Hungary five years ago from his native Germany. There, he says, most of the cost goes to lab technicians and salaries. Here, he uses the same materials, pays his staff better-than-average wages and still makes a bigger profit.

A word of caution
The British Dental Association (BDA) urged those thinking of traveling abroad for treatment to be cautious. They warned that if any complications develop when patients are home they may find local dental surgeons reluctant to take on responsibility for extensive treatment that was done another dentist, particularly one overseas.

As for calibre of care, the American Dental Association similarly offers caution. The concerns are not for the quality of dentistry received... but for the patient when it comes to long-term follow-up and possible complications. The term 'buyer beware' is very much in play here, as you may have fewer options after treatment if you feel it has not gone well.

That is one of the potential problems, finding aftercare in the home country for treatment that was done abroad. However, many patients are not worried about that as they are confident in the quality of the work they have received and believe the effort involved in traveling abroad is less stressful than the inconvenience of waiting for treatment in the UK.

All's well that ends well
Dentistry and tourism seem an ideal match. Patients are delighted, for example, to get all of their work done in one fell swoop. And once the major part was out of the way, stopping back for brief fittings left ample time for sightseeing.