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Family Health Magazine
DENTAL HEALTH

Travel Dentistry
A hitchhiker's guide to offshore dental care

Imagine taking a surgical holiday. You will be having cosmetic surgery done abroad in a tropical hotspot. No one knows what you are planning. All of the short-term healing, bruising and discomfort will be over by the time you return home, renewed and full of vitality.

Currently, there is a significant and ongoing trend for such vacations. Surgical holidays to eastern Europe, Mexico, India and many other countries have been expanded to include dental therapy. You can find many websites where happy consumers discuss their fantastic deals. They describe full mouth reconstruction, including crowns, bridges and dental implants, all done at bargain-basement prices.

While in many cases results are good, they don't always match North American expectations or standards. Extensive and expensive follow-up care and treatment is often required once the patient returns home.
Still, from a distance deals may seem amazing and impossible to pass up. Keeping a few simple guidelines in mind can help you decide whether the dentist and treatment plan you are considering is in fact a good idea.

Communication

Make sure you can communicate with the dentist - if not in English, in a language you both understand. Alternatively, have someone you trust translate for you.

Infection control

The possibility of infection is a real concern for foreign travelers having invasive treatments. Infection control practices help prevent the transmission of organisms that cause disease. These practices include:

• a clean, safe work environment
• hand washing by the dental care providers, with new gloves used for each patient
• use of personal barriers, such as face masks and eye glasses
• sterile instruments - either thorough cleaning of tools between patients, or use of instruments that are new and disposable.

If you are unsure about the dentist's infection control practices, ask. If you are still not certain, ask to take a look around the office. You should see a sterilization unit and the measures listed above in use.

Costs

It is the wise patient who realizes that there are both fixed and variable costs with any treatment. Short and long-term costs exist as well. Make sure you know all comprehensive costs before committing to treatment. Ask for a written cost estimate with the possibility of a pre-authorization from your insurance company. Are you sure your insurance company will pay for treatment abroad? Ask for approval in writing first. If they say no, you will have to pay for comprehensive treatment out of your own pocket.

Short-term concerns of dental treatment abroad

• Make sure that your dentist is qualified by an internationally recognized organization before beginning treatment. What exactly are the qualifications? Where did the dentist receive training? If this dentist came to Canada to work, would he or she be able to perform this procedure legally?
• If in doubt, contact your local Dental Association and College for further clarification.
• Follow the guidelines mentioned previously regarding infection control. Before you travel, ask the dentist to outline infection control practices in detail, either in an e-mail or a letter. If you do not see the same precautions in place when you arrive, leave. Never begin elective treatment in an unsafe environment.
• Ask many questions about the materials used. Check with board-certified specialists in your home province to make sure all materials are safe and tested.
• Not all countries follow the same guidelines or have the same expectations regarding how long a prosthesis, such as a crown, bridge, or implant will last. While you might expect it to last for the rest of your life, it may instead be a temporary procedure needing replacement in a few years.
• Ask whether there are any additional costs. Have you calculated in travel and accommodation costs? Will you need to spend all of your time recovering, or will you be free to play on the beach or explore your surroundings?
• Ask for referral names of previous patients from your area who have had similar previous treatment. Would they do this again? Did they experience any difficulties?

Long-term concerns of dental treatment abroad

What if something goes wrong? For instance, imagine that your restorations crumble and fall apart, or metal copings under the crowns leak so that cavities develop. Who will fix the problem? Who will be financially responsible for correcting the damage?

The bottom line is that you are personally responsible for paying for any repairs or revisions resulting from treatment you received out of country. When you have the ability to establish a relationship with and easily return to a particular clinician, the situation is very different. In other countries, different dental governing bodies monitor the dentist's work. Ignorance of the law will not protect you from fraud or shoddy work. It is both your right and your responsibility as a consumer to be fully aware of local governing bodies and guidelines.

If things go bad unexpectedly

Visit your local family dentist to discuss what happened and to explore your options. Can your dentist help with repairs, or do you need to see a specialist? If necessary, a board-certified prosthodontist can help you with a thorough treatment plan and outline the options and best path for you to follow.

The heart-racing excitement associated with a great deal encourages us to take impulsive risks when shopping. (Have you ever bought something you don't need at all just because it is inexpensive?) When it comes to invasive elective treatment, you take a significant risk if you choose an offshore, bargain dentist.

Your responsibilities

Keeping the following guidelines to help protect both your health and your pocketbook.

• All elective treatment should be done by a properly trained individual with your best interests at heart.
• You should be fully aware of all costs - short and long-term.
• The procedure must be done in a safe environment following high standards of infection control.
• You are prepared for any complications that occur along the way.

Regardless of whether the treatment you have in a foreign location is elective or an emergency, always make sure you feel comfortable with the environment and people involved. Your personal safety and health come first.