Dental tourism could be a bridge too far
By Angela Long
How far are you prepared to go for your teeth?
With the high costs of treatment in the Republic, the route north used to be a well-travelled one for those clutching their jaws in pain.
Staying at home means the agony is doubled. When the drilling stops, the excavation of the wallet begins.
A growing trend is to head to the airport and seek dentistry in a cheaper location, such as Hungary or South Africa. Dental travellers' tales are mixed, and some of these appear on irishhealth.com discussion boards.
Dublin is the most expensive place on the whole island to attend a dentist. A basic check-up starts around €90, and fillings range from €90-200 (the cheaper ones are the old-fashioned amalgam, the more expensive are made to look like actual teeth). Worst of all, from both discomfort and bank balance viewpoints, is the root canal, which costs around €600 in Dublin dentist clinics.
An irishhealth.com straw poll of charges around the country found that in Longford, a check-up was around €70, but this included a session with a dental hygienist. In Sligo, the figure was between €40 and €50. In Northern Ireland, Derry dentists quoted 25 pounds sterling for a check-up (about €38) and root canals started at £100 (€150 ≠ a quarter of the price in Dublin).
And all these rates apply at a time when dentists are voting overwhelmingly to withdraw from the medical card scheme, which since 1994 has made treatment free for low-income cardholders.
Ciara Murphy, spokesperson of the Irish Dental Association, said there was no recommended hourly rate for dentists to charge.
"It is a matter for each dentist to decide their own professional fee," Ms Murphy said.
She said it was actually prohibited for dentists to standardise fees or publish an hourly rate as this was anti-competitive.
"A dentist's rate will depend on where he is based, how large the practice, how long they have been established," she said. Ms Murphy said the overheads (rent, maintenance, operating costs) were on average 40-60% of a dentistís profit.
One option a growing number of Irish are taking is the all-in package ≠ flight, accommodation, transport to clinic, dental work, and then the journey in reverse.
A company offering treatment in Torrevieja, on Spain's Costa Blanca, quotes basic treatment (initial check, temporary fillings) as free, while a root canal costs from €100.
Hungary is campaigning strongly for dental tourism, and the national Tourist Office website even recommends the practice, claiming most dentists speak good English.
Dentalhungary.ie, which advertises widely, says most procedures involve a stay of just two or three nights in Budapest, the capital. The website compares the cost of 10 crowns in Dublin, excluding extra services, at €10,000, with Budapest, which would include temporary crowns, consultation, and full x-ray, for €2,890.
Spokesman Davor Nekderovic says there have, fortunately, been no problems since the company started operating in Dublin two years ago. Dentalhungary arranges trips for 20-25 people a month on average, he said.
"We deal with the dental clinics we have used ourselves in Budapest and found to be very good. We were the guinea pigs," he told irishhealth.com.
Ciara Murphy of the IDA says travelling abroad for dental work is a personal choice, but warned that the results of 'dental tourism' could be negative in the longer term.
"Patients sometimes fail to understand that the very short time in which a lot of work is done can have consequences," she said. She gave an example of a package of major work including two bridges and eight crowns. "In Ireland that would cost between €15,000-20,000. On the internet, you can probably find a price of €12,000.
"But the work abroad usually will be done within a week, even a weekend. At home it would probably be done over a six-month period."
Ms Murphy said this meant that the settling time needed by the teeth and mouth was not available.
"In some cases, work done under these circumstances will collapse within two years," she said.
"We see extreme cases, but they are utterly appalling," she said. "And also, there is work that is very good."
Both the Irish professional association and a pan-European group have researched the growing trend to travelling abroad for dental work. The Council of European Dentists prepared a paper on community health services which concluded that 'patient mobility' in seeking out services was not a good thing.
"The great majority of patients in the EU want to access healthcare close to home," it said. "The CED does not believe that patient mobility in the area of dental care should be actively promoted."
The Council said that language knowledge was important in patient-dentist dealings. It also noted that patients should always know, and plan for, time for post-treatment care.
Ms Murphy said the IDA has surveyed Irish dentists on this topic, and is collating the results now.
The Consumers' Association of Ireland (CAI) says people should be absolutely certain about the quality of treatment they are getting abroad. Dermott Jewell of the CAI said he felt dentists were losing out by not publishing a guideline to their fees, and being more active in explaining their costs.
"I think dentists are doing themselve some degree of disservice. They might not be able to advertise, but they can make comments and give guidelines on their prices," he said.
He said other countries had realised the advantages of attracting dental tourists, and were actively seeking them. Irish dentists needed to counter this.
Mr Jewell said some dental destinations were becoming more expensive, and people should be wary of higher costs than they anticipated.
Discussions on this topic are now closed.