A dentist's top tips for avoiding a dental travel smile disaster

I'm off to Thailand for a mid-winter break this week. As I hit google to search for background knowledge, activity inspo and general lowdown, I was blasted with dental tourism advertising. To my surprise, Thailand is also THE place to get a smile makeover holiday. 

Experts in health - a cautionary tale

It's natural to think that because we can get a five or even seven star holiday for the same cost or cheaper than travelling domestically, the same must apply to medical procedures. Unfortunately this analogy does not hold true.

Precision parts made out of quality biocompatible materials fit for human use are not bought in bulk from an e-commerce store. They are developed by specialised companies that require licences and government approval to be imported and placed by professionals with appropriate training. While the service overseas may be fantastic, the medical operational safety and standards are often not the equivalent of home. You rarely drink the tap water in such places afterall!

When you have a medical device or implant fitted you definitely need the designer original, not a cheap knockoff that falls apart, the cost of compromise can be super expensive!

3 horrific things I've seen go wrong with cheap complex overseas dentistry

1. Cheap unknown components such as implants and copings, often poorly placed, the next dentist can't fix

Nothing lasts forever, your original teeth were meant to. There's an 80-95% 10-year life expectancy rate for implants, depending on the site they're placed. This reduces to slightly less than 50% for anyone who smokes. Implants work like Meccano sets that have special keys and tools for different brands. If the next dentist cannot determine what type you've had placed, they'll be struggling to help you. 

Cheap implants generally use cheap materials. These are less likely to be biocompatible to human tissues, increasing the likelihood of allergy, infection and huge failure. Poorly placed implants may not be able to be used and destroy viable tissue, or the position of the overlying restoration is compromised for function or aesthetics.

2. Poor infection control standards can lead to ugly infectious extras

In most of the countries offering dental tourism, it's advised to avoid drinking the tap water. Anyone who's experienced Bali-belly still doubles over at the thought of the experience, often years later. Having complex dentistry done is often a highly invasive procedure. Much of the expense of dentistry in Australia comes from ensuring the highest hospital-like quality control standards are met. There are more than a few dental gallivanters who've returned with an infectious disease such as Hepatitis or HIV along with their new smile, far worse than a stomach upset or lingering parasite.

3. Poorly made crowns and veneers quickly chip and ruin that Hollywood smile

I've seen my fair share of crowns and veneers done overseas for cheap. Often the cosmetic appearance doesn't harmonise with the person's face. They can be too short, too long, too wide or poorly contoured. Saving a few grand to end up looking like Bugs Bunny or Pop Eye is a false economy. The component connections often aren't smooth, leading to chronic gum inflammation and infections that look unsightly and can accelerate failure. The bond between ceramic, tooth and metal is a complex and tense one. Cheaper materials often don't bond well, for long in a wet mouth, propagating cracks that splinter off in the aesthetic zone. There's only one way to fix cracked porcelain properly and that's to cut it off and start again. Sadly no savings there!

5 recommendations for dental tourism safety

1. Don't do it. There is no bargain in dentistry. You get what you pay for. Medical is expensive for good reason - the best materials need to function for as long as possible in you. It costs even more to replace it when it goes pear-shaped. How much would you compromise on quality in your own industry? Why? Why not?

2. Find out what brands of materials the dental practice will be using. Research these. If they aren't used in your home country, or if there isn't a sales rep for them in your own country, don't get it. It can quickly get expensive if you have to fly overseas to get a screw tightened or some routine maintenance that would cost a lot less back home if it could be done.

3. Get precious noble metals and highest quality titanium. These are the most biocompatible materials for human tissue, reducing the risk of ugly metal tattoos, allergies, infections or body rejection.

4. Read the national hospital infection control guidelines of your home country. Understand that anything reusable going into your mouth should come out of a sterilised autoclaved bag with a colour indicator that has changed colour after a specific period of time at a certain temperature and pressure. Is the water filtered and distilled? Are the sharps and disposables being used once only? Do the staff wear gloves and wash their hands after taking them off? How clean is the floor? 

5. Find out what kind of warranties the dental practice provides you for the work being done. How does that compare to your home country for the same work? How will they remotely manage your situation in the event of a problem? How much would this cost? What are your rights if it came to a medico-legal complaint in another country? 

Good luck and best wishes. I'm off to enjoy warm beach weather, daily massages and delicious fresh food!

By Dr Christine May, Principal Dentist and Founder of ViDe and FaceWell.

All information in this article is of a general nature only and does not replace any specific personalised advice provided you by a health practitioner following a consult.