Risks of Foreign Dental Care

This may become a permanent link on the site, but this article should be well understood. Dr Timmerman often sees people that have sought to save money by leaving the country, only to have work done that had unnecessary risks involved. Poor sterilization, inferior skills and simply poor results are not uncommon.

Why you should be wary of going to a foreign dentist in search of that Bollywood smile
By Tariq Idris
Last updated at 12:39 AM on 6th June 2010

My first patient of the day was a middle- aged woman whose face was totally misshapen. She had been on holiday to India to have dental implants. The procedure had gone wrong but her fears had been dismissed despite the pain.
On her return, she had been admitted to Manchester’s Royal Infirmary where doctors confirmed she was suffering from a blood infection.
Her implants had to be removed, as did some of the jaw bone, and she was warned that should she ever want implants again she would need a bone graft.
The poor woman could not face any more expensive procedures and I had to fit her with false teeth.

Shining example: Actress Davinia Taylor shows off her home-grown smile with Tariq Idris
Her story is a stark warning of the dangers that patients face when they travel abroad for what they believe is a bargain.
Unfortunately she is not the first such case I have seen  –  nor is she likely to be the last. That is why I want to warn patients about the risks involved. Weigh up everything before undergoing treatment abroad.

I invite anyone planning to go abroad for expensive treatments such as implants, crowns or veneers to get a second opinion from me.
I have worked in the industry for 15 years and my patients have included former Hollyoaks actress Davinia Taylor, singer Charlotte Church and England footballer Steven Gerrard.
I am happy to assess whether patients’ treatment plans are correct and whether they could save money by staying in this country. They can even scan in X-rays and send reports online.

But why the sudden desire to go abroad? Let me explain.
Since the new contract for NHS dentists was introduced in 2006, people are finding it harder to locate an NHS dentist: only 26.9 million people  –  about half the population  –  saw a dentist in the two years following the reforms, a drop of 1.2 million from the two previous years.
Dentists are no longer paid different fees for each treatment. They get lump sums instead, meaning they find it less cost-effective to carry out difficult, time-consuming procedures.

Recent statistics have revealed that the number of treatments such as crowns, bridges and dentures has plummeted by 57 per cent since the system was introduced.
Meanwhile, the number of patients having teeth extracted in hospital has risen by a third from 135,000 in 2003/4 to 175,000 between 2007/8.
How awful is that in 21st Century Britain? There is also a rise in the number having implants  –  artificial titanium tooth roots  –  inserted into the gums to support crowns, bridges and dentures.

There has been a culture shift away from dentures. People are keen to look and feel younger and more attractive. Even 20 years ago, a pensioner might have accepted that they would end up wearing dentures; nowadays that’s something most try to resist.
However, implants are expensive. We have 28 teeth, excluding wisdoms, and costs can vary from £2,000 to £2,500 a tooth. I have seen treatment plans in this country approaching £100,000.
But that is because about half of all patients wanting implants need bone augmentation. In the most severe cases, bone is removed from the hip and implanted in the jaw.
And that is why many people go abroad. They do not want dentures and fear the costs in this country will be prohibitive. Yet often the service abroad is no cheaper.

Foreign clinics may market an implant in basic terms as costing about £400 to £500. But that is not the whole picture.
Firstly, that price does not include the tooth or any bone graft  –  just the screw.
Secondly, patients often do not actually need the number of implants or the grafting for which they have been quoted. Thanks to modern science and research, we now know that you do not need 14 implants to replace a top jaw  –  but a smaller number of pegs with a bridge between them.

You might need only six implants to support a whole jaw and sometimes you can get away with as few as four.
People may be persuaded to have teeth extracted unnecessarily and more implants than they need, both of which push up the cost. They are often told they need bone grafting when they may not necessarily.
A handful of patients I have already given a second opinion to have said: ‘Wow. I don’t need a bone graft? Forget the money. This is saving me from going through a pretty horrendous operation.

The Hollywood smile is a combination of veneers, crowns and bridges, for which you can pay anywhere between £8,000 and £20,000.
But often the treatments recommended abroad are not appropriate, for example if the patient has a gum problem. Dentists here would not advise veneers or crowns until that was fixed. Otherwise the patient would end up with more problems and could even lose all their teeth.
There is also a potentially serious problem if the veneer is not fitted properly  –  it will not look good and could trap plaque and cause gum inflammation. And if the tooth is not drilled correctly there is a real risk of damaging the nerve.

Then you have the costs of booking a flight, taking time off work and dealing with any problems on your return.
The key thing to remember is that whether you plump for Eastern Europe or Asia, you are not covered by British regulations.
Here we have a system where you can go back to your dentist, which is regulated by a governing body, or complain to the Parliamentary and Health Service Ombudsman.
And, ironically, about half the patients I have seen who have had procedures abroad would have paid the same, or even less, in the UK.