Dental Tourism, Dangerous Travel?
Thursday July 3, 2008 

Dear Dr. Mady: I have seen two different dentists for quotes on the treatment that I require on my teeth. It involves a few root canals, a bunch of crowns and two bridges to replace some of my missing teeth. My dental plan only covers me up to $1500 per calendar year and none of that can be used for any of the major work. A few weeks ago I read an article from an experienced physician/journalist that talked about the money that can be saved by traveling to another country to get all my dental work done. Do you think this is an option and would you advise it to me or anyone who can not afford the treatment they need?—Maria in Windsor


Dear Maria: I have read similar articles myself in recent times. Being an experienced dental practitioner for over fifteen years (and my dad for over fifty years), I have seen a lot with respect to quality versus inferior dental treatment. It is just like the phone calls we all get while having dinner from time to time. The phone rings and either a computer or an individual proclaims that you have been chosen as the recipient of a free vacation or cruise. Remember, if it sounds too good to be true, 99.9 percent of the time it is.

Dental vacations or dental tourism refers to people looking for dental treatment outside of their local health care system in another country. This is mostly for economic reasons and what initially motivates them. This trend is becoming more popular because of marketing tactics that make it sound very appealing with special pricing and/or descriptions of exotic destinations.

Many blame the disturbing and growing trend to increasingly inadequate dental plans that fail to reimburse patients properly for anything other than routine exams and dental emergency procedures. Even worse is the growing number of individuals with no benefits due to loss of jobs, being self-employed, cut-backs and poor nationwide economic conditions.

We have all seen it, especially internet users. There are special offers for “Dental Vacations” like Africa, Croatia, Hungary, India, Thailand, Costa Rica and Mexico to name a few of the more popular destinations. There are advertisements for special discounts for the dental tourists and luring statements like “get your teeth fixed while you get a tan”. Some sites even have a form for a patient to fill out so they can get a quote e-mailed back to them. Anyone who uses common sense understands that without a proper clinical examination and diagnosis, it is impossible to obtain an accurate estimate of costs for treatment.

You have to first realize that these dentists and dental specialists often do not comply with the same standards as dental practitioners in Canada and the United States. We have provincial, state and federal laws that regulate us here at home, including continuing education requirements. We have dental school accreditation and professional association review committees also that set the standards higher for practicing dentists in Canada and the United States. We do not factually know what goes on in other countries and promoters are not going to tell the whole story. There are language barriers and often no informed consent is obtained prior to treatment. They understand that the only real thing that you think you are consenting to is saving money!

You should consider that there is a possibility of dangers involved in dental tourism, and not only related to an unknown physical environment. Dentists and dental labs in other countries may use inferior quality or black market dental materials for restorations and other procedures. What are the sterilization standards for these dentists and labs? Who really knows? Recently I heard on the news about some cheaper labs in China fabricating crowns that contain lead and some even had e. coli.

Treatment in other countries can not be guaranteed. If someone undergoes services in another country, they usually have to pay more to fix the problems that occur when they return home, and there is a possibility of permanent damage. Are you going to pay for a flight to go back where you had the job done initially? Probably not! You also have to realize the differences in the legal systems of other countries compared with your own. In cases of gross negligence, you probably would not even be able to sue for damages. Even if you could, the entire drawn out process would be in the jurisdiction where the treatment was given and it would be a financial and emotional nightmare.

Myself and many of my colleagues have witnessed our patients go to Europe or the Middle East often for vacations or to visit family and to return with a mouth full of new restorative dentistry. We have seen everything form purple bleeding gums due to impingement on tissues to failing root canals that are filled ten millimeters short of the apex (end of the root) to crowns and bridges with heavy open margins that one could do chin-ups on. Five years later, these individuals are losing their teeth for related reasons. Some local dentists may not even treat you after foreign procedures have been completed. In most cases they can not even consult with the foreign caregiver if needed and he or she will be free of legal recourse, and the local dentist could end up liable for complications arising from treatment after dental tourism.

The only thing you will be guaranteed on a dental vacation is a large amount of work in a short period of time and a whole bunch of associated risks that you don’t think about or even realize exist. Your dental insurance will not pay anything towards the foreign treatment. If you add up the cost of travel, lodging, food, car rental, entertainment, shopping, travel medical insurance, extras they will find once you get there, and the cost of follow-up treatment back home, you will diagnose that it would have been better to have seen a practitioner locally and cheaper. The most important thing is that you know you are getting quality work that will last.

For any questions, please e-mail Dr. Mady at and look soon for his new blog at (dental education network)


This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5



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