Dental tourism

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Dental tourism (also called dental vacations or commonly known as dental holidays in Europe) is a subset of the sector known as medical tourism. It involves individuals seeking dental care outside their local healthcare systems and may be accompanied by a vacation. Dental tourism is growing worldwide; [1] as the world becomes ever more interdependent and competitive, technique, material, and technological advances spread rapidly, allowing providers in developing countries to provide dental care at significant cost savings when compared to their peers in the developed world.

Contents

Reasons for travel

While dental tourists may travel for a variety of reasons, their choices are usually driven by price considerations. [2] [3] Wide variations in the economics of countries with shared borders have been the historical mainstay of the sector. Examples include travel from Austria to Croatia, Albania, Ukraine, Hungary, Slovakia, Slovenia, Bosnia, Bulgaria and Romania, [2] from the US and Canada to Mexico, Costa Rica, Ecuador and Peru, from the Republic of Ireland to Northern Ireland, Croatia, Hungary, Ukraine, Poland, Bulgaria and Turkey, and from Australia to Thailand, India and other countries of South-East Asia and Middle-east including Doha-Qatar. [4] [5] While medical tourism is often generalized to travel from high-income countries to low-cost developing economies, other factors can influence a decision to travel, including differences between the funding of public healthcare or general access to healthcare. [3]

Mobility of labour

For countries within the European Union, dental qualifications are required to reach a minimum approved by each country’s government. [6] Thus a dentist qualified in one country can apply to any other EU country to practice in that country, allowing for greater mobility of labour for dentists (Directives typically apply not only to the EU but to the wider designation of the European Economic Area - EEA). [7] The Association for Dental Education in Europe (ADEE) has standardization efforts to harmonize European standards. Proposals from the ADEE's Quality Assurance and Benchmarking task-force cover the introduction of accreditation procedures for EU dentistry universities as well as programmes to facilitate dental students completing part of their education in foreign dentistry schools. [8] Standardization of qualification in a region reciprocally removes one of the perceptual barriers for the development of patient mobility within that region.

Pricing and quality

Dental tourists travel chiefly to take advantage of lower prices. Reasons for lower prices are many: dentists outside the "developed world" are able to take advantage of much lower fixed costs, lower labor costs, less government intervention, lower education fees and expenses, and lower insurance costs. The flip-side of this is less legal recourse for patients when something goes wrong, but the result is that procedures, such as dental implants and porcelain veneers, which are simply financially out of reach for many people in the developed world, are made affordable overseas.

Much of the debate about dental tourism and medical tourism in general centers on the question of whether or not price differentials imply quality differentials. Another concern is whether or not large scale dental procedures can be safely completed abroad in a relatively short, "holiday-sized" time period. Another issue affecting this debate is the lack of an independent inspections committee for dental similar to the Joint Commission International for medical.

An instructive case study an analysis of patient outflows from the United Kingdom and Ireland, two large sources of dental tourists. Both countries were the subject of a report from the Irish Competition Authority to determine whether consumers were receiving value for money from their dentists. [9] Both countries’ professions were criticized for a lack of pricing transparency. A response to this is that dentistry is unsuitable for transparent pricing: each treatment will vary, an accurate quote is impossible until an examination has occurred. Thus price lists are no guarantee of final costs. Though they may encourage a level of competition between dentists, this will only happen in a competitive environment where supply and demand are closely matched.

The 2007 Competition Authority report in the Irish Republic criticised the profession on its approach to increasing numbers of dentists and the training of dental specialties – orthodontics was a particular area of concern with training being irregular and limited in a number of places. Supply is further limited as new dental specialties develop and dentists react to consumer demand for new dental products, further diluting the pool of dentists available for any given procedure.

Aside from the above issues, it is possible to compare the prices of treatment in different countries. With the international nature of some products and brands, it is possible to make a valid comparison. For instance, the same porcelain veneer made in a lab in Sweden can be as much as 2500 AUD in Australia, but only 1200 AUD in India. The price difference here is not explainable by reference to the material cost. [10]

Clearly, undergoing extensive dental procedures abroad, even when allowing for travel expenses, can be significantly cheaper than the same procedures at home. Pricing and qualifications of the dentists may be researched through websites or by contacting the dentists.

Another important consideration is location: if one travels far for a dental procedure and something goes wrong, it is a long way to return to fix it as well.

Many[ citation needed ] Americans choose to go somewhere relatively accessible from the US, such as San Salvador, Tijuana, Los Algodones, Tecate, Agua Prieta or Lima. Due to the ongoing narco-violence in towns such as Tijuana and Ciudad Juarez, clinics in safer towns 1,000 miles south of the border - Cabo San Lucas, San Jose del Cabo, Puerto Vallarta, Cancun, Playa del Carmen and Cozumel Mazatlan etc. have recently started offering large and small dental treatments. (See info below.) More than 70 percent of Mexico’s US patients travel from the border states of California, Texas, or Arizona [11]

Since procedures often require multiple steps, or subsequent checkups, the patient may have to return to the same doctor for those reasons. Typically, a patient takes two trips to have implants. The first trip is to set the base and the provisional crown. The second trip is typically 4–6 months later after the implant has stabilized in the bone. One Day Implants are not recommended for dental tourists due to the higher failure rate of the system.

When combined with a holiday, as the name implies, dental tourism can be an opportunity to receive low-cost, quality dental care. Dental tourism is expected to continue growing, as consumers continue to seek out lower-cost options.

Related Research Articles

Dentistry Branch of medicine

Dentistry, also known as dental medicine and oral medicine, is a branch of medicine that consists of the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity, commonly in the dentition but also the oral mucosa, and of adjacent and related structures and tissues, particularly in the maxillofacial area. Although primarily associated with teeth among the general public, the field of dentistry or dental medicine is not limited to teeth but includes other aspects of the craniofacial complex including the temporomandibular joint and other supporting, muscular, lymphatic, nervous, vascular, and anatomical structures.

Dentist Healthcare occupations caring for the mouth and teeth

A dentist, also known as a dental surgeon, is a surgeon who specializes in dentistry, the diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.

Medical tourism refers to people traveling abroad to obtain medical treatment. In the past, this usually referred to those who traveled from less-developed countries to major medical centers in highly developed countries for treatment unavailable at home. However, in recent years it may equally refer to those from developed countries who travel to developing countries for lower-priced medical treatments. The motivation may be also for medical services unavailable or non-licensed in the home country: There are differences between the medical agencies world-wide, whether a drug is approved in their country or not. Even within Europe, although therapy protocols might be approved by the European Medical Agency (EMA), several countries have their own review organizations in order to evaluate whether the same therapy protocol would be "cost-effective", so that patients face differences in the therapy protocols, particularly in the access of these drugs, which might be partially explained by the financial strength of the particular Health System.

Cosmetic dentistry is generally used to refer to any dental work that improves the appearance of teeth, gums and/or bite. It primarily focuses on improvement in dental aesthetics in color, position, shape, size, alignment and overall smile appearance. Many dentists refer to themselves as "cosmetic dentists" regardless of their specific education, specialty, training, and experience in this field. This has been considered unethical with a predominant objective of marketing to patients. The American Dental Association does not recognize cosmetic dentistry as a formal specialty area of dentistry. However, there are still dentists that promote themselves as cosmetic dentists.

Prosthodontics, also known as dental prosthetics or prosthetic dentistry, is the area of dentistry that focuses on dental prostheses. It is one of 12 dental specialties recognized by the American Dental Association (ADA), Royal College of Surgeons of England, Royal College of Surgeons of Edinburgh, Royal College of Surgeons of Ireland, Royal College of Surgeons of Glasgow, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons. The ADA defines it as "the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth or oral and maxillofacial tissues using biocompatible substitutes."

The UCLA School of Dentistry is the dental school of the University of California, Los Angeles (UCLA) located in the Center for Health Sciences building in the Westwood neighborhood of Los Angeles, California, United States. The school has several educational and training programs, conducts oral and dental health research, and offers affordable dental care at three locations: Westwood, Venice, and Inglewood. The school also participates in several outreach endeavors, including numerous health fairs during the year, STEM pipeline programs and provides dental care for underserved populations in the region. The School of Dentistry is considered among the nation's best research-intensive dental schools.

Dental insurance is a form of health insurance designed to pay a portion of the costs associated with dental care. There are several different types of individual, family, or group dental insurance plans grouped into three primary categories: Indemnity, Preferred Provider Network (PPO), and Dental Health Managed Organizations (DHMO).

Denturist Healthcare occupation caring for the mouth and teeth

A denturist in the United States and Canada, clinical dental technologist in the United Kingdom or a dental prosthetist in Australia, is a member of the oral health care team and role as primary oral health care provider who provides an oral health examination, planning treatment, takes impressions of the surrounding oral tissues, constructs and delivers removable oral prosthesis treatment directly to the patient.

Dental education throughout the world

Dentistry throughout the world is practiced differently, and training in dentistry varies as well.

Due to the near-universal desire for safe and good quality healthcare, there is a growing interest in international healthcare accreditation. Providing healthcare, especially of an adequate standard, is a complex and challenging process. Healthcare is a vital and emotive issue—its importance pervades all aspects of societies, and it has medical, social, political, ethical, business, and financial ramifications. In any part of the world healthcare services can be provided either by the public sector or by the private sector, or by a combination of both, and the site of delivery of healthcare can be located in hospitals or be accessed through practitioners working in the community, such as general medical practitioners and dentists.

Health care in Australia

Australia has a highly developed health care structure, though because of its vast size, services are not evenly distributed. Health care is delivered in Australia by both government and private companies which are often covered by Medicare. Health care in Australia is largely funded by the government at national, state and local governmental levels, as well as by private health insurance; but the cost of health care is also borne by not-for-profit organisations, with a significant cost being borne by individual patients or by charity. Some services are provided by volunteers, especially remote and mental health services.

A medical tourism agent is an organisation or a company which seeks to bring together a prospective patient with a service provider, usually a hospital or a clinic. These organisations are generally facilitators and developers of medical tourism, which brings into play a number of issues that do not apply when a patient stays within their own country of origin.

Medical tourism in Israel is medical tourism in which people travel to Israel for medical treatment, which is emerging as an important destination for medical tourists. In 2006, 15,000 people came to Israel for medical treatment, bringing in $40 million in revenue. In 2010, Israel treated 30,000 medical tourists. The Health Ministry estimates that they inject about NIS 200 million a year into the health system, of which more than NIS 100 million goes to government hospitals. Outside experts put the total much higher, at almost NIS 500 million.

Special needs dentistry, also known as special care dentistry, is a speciality of dentistry concerned with the oral health of people who have intellectual disability, or who are affected by other medical, physical, or psychiatric issues.

Medical tourism is a growing sector in India. In October 2015, India's medical tourism sector was estimated to be worth US$3 billion. It is projected to grow at a CAGR of 200% by 2020, hitting $9 billion by 2020. In 2017, 495,056 patients visited India to seek medical care. The top 10 source countries for patients have been Bangladesh, Afghanistan, Iraq, Maldives, Oman, Yemen, Uzbekistan, Kenya, Nigeria and Tanzania, with significant number of patients also coming from Australia, Canada, Russia, the UK, and the United States. The city of Chennai has come to known as the healthcare capital of India.

Medical tourism in Pakistan is viewed as an untapped market that could be turned into a huge opportunity if the government "focuses on key issues". According to Pakistani medical experts, Pakistan has a "huge potential" in becoming a regional medical tourism hub, comparable to many other countries in its neighbourhood. Medical tourism in Pakistan has been arranging potential trips for many medical health and care procedures. A number of modern hospital facilities exist in major cities such as Islamabad, Karachi and Lahore that are fully equipped and facilitated with the latest medical technologies. Many doctors and surgeons in Pakistani hospitals tend to be foreign qualified. However, security issues and an overall below-par health infrastructure have challenged the growth of the industry.

A dental discount plan, also known as a referral plan, is a membership-based discount plan for dental health maintenance and intervention. In it, the patient pays the entire cost of a rate negotiated between the dentist and the referring company, usually between 10-60% of normal cost.

Medical tourism in the Republic of Moldova – is the branch of the tourism industry, providing the high-level treatment to the foreign patients. This industry gains more popularity each year and the number of medical tourists exceeds 30% of the total number of patients in Moldova’s clinics. Foreign citizens come to Moldova for qualitative treatment, which they cannot receive or allow in the country of origin.

Dental aerosol Hazardous biological compound

A dental aerosol is an aerosol that is produced from dental instrument, dental handpieces, three-way syringes and other high-speed instruments. These aerosols are air suspended in the clinical environment. These aerosols can pose risks to the clinician, staff and other patients as well. The heavier particles of the aerosols suspend in the air for relatively short period and settles down quickly, but the lighter particles tend to remain suspended for longer periods and are capable to enter and get deposited in the lungs when they are inhaled and possess the capacity of transmitting diseases.

References

  1. ↑ "Archived copy" (PDF). Archived from the original (PDF) on 2012-10-02. Retrieved 2012-08-08.CS1 maint: archived copy as title (link)
  2. 1 2 "Cross-border care in the south: Slovenia, Macedonia, Austria and Italy" [ permanent dead link ] WHO Report on patient mobility (retrieved 19 October 2007)
  3. 1 2 "Catherine McNerney and Desmond Gillmor" Experiences and perceptions of rural women in the Republic of Ireland: studies in the Border Region (retrieved 19 October 2007)
  4. ↑ "List of hospitals in Qatar", Wikipedia, 2019-07-12, retrieved 2019-07-20
  5. ↑ "Reem Medical Center". www.reemmedicalcenter.com. Retrieved 2019-07-20.
  6. ↑ EC Dental Directives (78/686 and 78/687 EEC) (retrieved October 19, 2007)
  7. ↑ "EU Manual of Dental Practice" Includes comparative study of member countries dental systems: 3rd edition currently in preparation (retrieved 19 October 2007)
  8. ↑ "ADEE Taskfore document on quality assurance and benchmarking (retrieved October 25, 2007)" (PDF). Archived from the original (PDF) on November 27, 2007. Retrieved July 22, 2019.
  9. ↑ Irish Competition Authority Report (retrieved 19 October 2007)
  10. ↑ "More Fun Than Root Canals? It’s the Dental Vacation", New York Times, 2008-02-07
  11. ↑ Patients Beyond Borders
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