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The drill on dental tourism

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Filed: Other Country: Canada
It was going to cost Greg Crawford "half of my arm and half of my leg as well" to lose all of his teeth. After 40 years of watching his teeth literally fall apart despite spending thousands of dollars on dental treatment, a dentist gave him a quote of nearly $30,000 to pull the lot out.

"My teeth were just absolutely shot. From a small kid, I just had problem after problem after problem. I would go to dentists, get fillings, and three months later they would fall out. [i am] just a freak, I think," Crawford says.

"I got to the stage where I had no self-confidence at all. My teeth were that bad, some of them were right down to the gum, just because they were breaking off. I didn't want to spend any more money on them."

So the Gold Coast painter turned to the internet to search for an alternative. He landed on the website of Dental Express, a company set up by a man based in Orange by the name of David Stuart, and was on a plane to the Philippines for his dental treatment - at a third of the price - only a month later.

"Dental tourism" is the catchy name for a growing industry attracting Australians to countries such as the Philippines, Thailand, India, Hungary or Poland for major dental work. It has followed the boom in "medical tourism", where people travel overseas for cheaper cosmetic and other surgery.

The trips often combine daily appointments in the dentist's chair with sightseeing, shopping, massages or day spa treatments, and result in a new set of choppers at a significantly reduced cost.

Advocates say the quality of the dental work is comparable with that received in Australia; detractors say that if it sounds too good to be true, it is. But with dental bills causing as much pain as the dentist's drill, many are prepared to take the chance.

The fees charged by dentists rose by 9per cent between 2006 and 2007, and by 49 per cent since 2002, according to the Australian Health Insurance Association, the peak body for private health funds.

The benefits paid by the funds were failing to keep pace, rising by 33 per cent over the five years, leaving patients to pay the widening gap. And the new Federal Government looks no more likely than previous governments to bring dental work under Medicare.

There is no record of exactly how many Australians go overseas for dental work, but the best estimate is several hundred each year, and rising steadily. In the United States, it is estimated that about 200,000 people sought dental treatment overseas in 2006 - a figure that had grown at least three-fold in only two years.

They are usually the worst cases: people requiring complete restoration of teeth, gums and even the jawbone, who have been quoted the value of a luxury car to have the work done at home.

But that's where the danger comes in, warns the president of the Australian Dental Association, John Matthews. The most difficult cases need the most complex treatment, often including considerable "work-up" - treatment to improve the condition of gums and bone, or the taking of dental impressions, in the lead-up to surgery - as well as continuing maintenance afterwards. Such cases would take months to treat in Australia, but the overseas surgery is often completed in just two or three weeks.

"Most people who do these trips do it for fairly complicated dentistry. The more complex it is, the more likely it is to fail," Matthews says.

"This is all no-brainer stuff. What happens if it does go wrong? … Maintenance is quite a problem. It's mostly our specialists who get these people when they have failed. It's mostly rushed work, and the complications of rushed work, that we see."

Matthews warns that the quality of materials used in some foreign clinics can be inferior to those used in Australia. He recalls seeing one patient who had received poor-quality gold fillings that contained a high level of copper, and there has been a recent scare in the US over dodgy dentures, veneers, bridges and crowns manufactured overseas.

Patients also put themselves at risk because foreign clinics do not have to abide by the regulations that apply to dental qualifications, infection control and blood control in Australia. "Can you, as a layperson, assess whether the person is competent? You have got the regulatory protection here that you don't necessarily have overseas," Matthews says.

The Melbourne dentist Richard Skinner says it is difficult to compare dental work done in Australia with cheaper foreign work because the general standard of living in countries such as Thailand and the Philippines is lower. Dentists trained in those countries often do not abide by the same standards of care expected in Australia, he says.

"It's hard to compare apples with pears. If you were going to buy yourself a Rolex watch, it's basically going to cost the same all over the world," Skinner says. "If you want to get a copy of a Rolex watch, you can get one in Thailand or the Philippines for $12 or $15."

But Matthews concedes it is possible for dental holidays to be a success. "I'm sure there are lots of people walking around with quite good work. I certainly wouldn't be that conceited to say the only good dentists are in Australia or all Australian dentists are good dentists."

Crawford is one of many happy customers who swear by the overseas treatment. In his case, the Manila dentist Rowena Marzo was able to save six bottom teeth. His top teeth have been replaced by a denture, while bridgework and implants have replaced the rest of his bottom teeth. His treatment has required two trips - time was needed between visits to allow his jawbone to regrow - and he returned to Manila in April for the second stage.

Rae Panton also visited Marzo's clinic last year after being quoted $11,500 by an Australian dentist for three bridges and the rebuilding of four bottom teeth. The Dental Express quote for the same work was about $2300.

But on arriving in Manila, Marzo suggested a different approach and Panton was happy to comply. She ended up with top-of-the-line crowns on every tooth, three bridges, three root canals and a mouthguard she uses while sleeping to prevent damage from grinding her teeth. The cost was about $13,500 but Panton can't help smiling.

"I just thought, 'Hang the expense' … If I had known earlier, I would have done it straight away. I don't put my hand over my mouth when I speak any more," says Panton, who had twice-a-day appointments spread over nearly three weeks.

A girlfriend who travelled with her for company was so impressed with the clinic she also had six crowns fitted while they were there. Panton's advice to others considering dental work overseas is to ensure they allow a few extra days at the end of their visit to allow their new teeth to settle.

David Stuart, a cartoonist by profession, set up Dental Express about two years ago after he sought treatment from Marzo. He had been quoted more than $40,000 to restore his damaged smile in Australia, but the same work in the Philippines cost about $11,000.

He has since established a business partnership with Marzo, whose dental team has trained in the United States, Germany and Switzerland. About a third of the clinic's business now comes from overseas, and Stuart is sending about 10 Australians over each month.

Stuart says the savings come about because of the greatly reduced cost of living in Asia, Eastern Europe and South America.

Like most agencies arranging overseas work, Stuart's clients who are after overseas treatment are first asked to send their Australian quote, and photographs and X-rays of their teeth, to the agency or foreign clinic.

A quote is then prepared, but treatment recommendations can change once the patient sits in the dentist's chair. Stuart was lucky; his health fund is one of a rare few to reimburse some of the cost of his treatment, the only proviso being that the bill was in Australian dollars. Most people with health cover won't get any benefit.




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Filed: Citizen (apr) Country: Brazil

oh noes more drilling threads!

* ~ * Charles * ~ *

I carry a gun because a cop is too heavy.



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